The Russian left-hander, whose only previous title came when she won Eastbourne in 2010, withstood a strong challenge in both sets, but her greater consistency and more aggressive play in the tiebreak earned her a victory.
Pliskova, who was also seeking her second career title after winning in Kuala Lumpur in February 2013, struck six aces in her opening service game but still had to fight off two break points before holding for 1-1.
She then failed to convert three break points on Makarova's serve in the next game and went on to lose her serve at 4-3 in the only break of the match when she hit a forehand long.
The second set went with serve, with Pliskova failing to convert two further break points to lead 4-2.
In a dramatic finale, Makarova built a 5-2 lead in the tiebreak but faced set point at 6-5 after she netted a smash.
Pliskova though hit her only double-fault of the match and also failed to win a second set point at 7-6 before Makarova secured victory on her first match point.