Objective To observe the effect of predictive nursing on breast aesthetics after breast conserving surgery for breast cancer. Methods From May 2022 to February 2023, 44 patients who underwent plastic breast conserving surgery for breast cancer in our hospital were selected as the research objects. They were divided into control group and study group by random number table method, with 22 patients in each group. The control group was given routine nursing, and the study group was given predictive nursing. The breast aesthetics, breast aesthetics effect and psychological status of the two groups were compared. Results The scores of nipple longitudinal displacement distance, nipple transverse displacement distance, breast depression degree, scar hyperplasia and breast symmetry in the study group were higher than those in the control group (P<0.05). The excellent and good rate of breast aesthetics in the study group was 90.91%, which was higher than 59.09% in the control group (P<0.05). After nursing, the HAMD score and HAMA score of the study group were lower than those of the control group (P<0.05). Conclusion Predictive nursing for patients with breast cancer after breast conserving surgery can effectively improve breast aesthetics, enhance breast aesthetics effect, and help regulate patients' bad mood, which is worthy of clinical application.