Objective To explore the influence of conceptual reconstruction and cognitive management combined with encouragement-education-exercise-work-evaluation rehabilitation model on rehabilitation effect in patients with craniofacial burn scar plastic surgery. Methods A total of 60 patients who underwent scar plastic surgery after craniofacial burn admitted to Nantong First People's Hospital from June 2024 to November 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 30 patients in each group. The control group received conventional perioperative nursing and rehabilitation guidance for burn scar plastic surgery, and the observation group received conceptual reconstruction and cognitive management combined with encouragement-education-exercise-work-evaluation rehabilitation model. The scar status, quality of life and mental state were compared between the two groups. Results The scores of each dimension and total score of VSS in the observation group were lower than those in the control group (P<0.05). The scores of physiological function, emotional role and social function in the observation group were higher than those in the control group (P<0.05). The scores of SAS and SDS in the observation group were lower than those in the control group (P<0.05). Conclusion Conceptual reconstruction and cognitive management combined with encouragement-education-exercise-work-evaluation rehabilitation model can effectively improve scar appearance in patients with craniofacial burn scar plastic surgery, help to relieve negative emotions and improve quality of life, which is worthy of clinical application.