To analyze the effect of high quality nursing service on incision scar and aesthetics in patients undergoing breast surgery. Methods A total of 200 patients who underwent breast surgery in our hospital from February 2022 to February 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 100 patients in each group. The control group was given routine nursing, and the observation group was given high quality nursing service. The breast incision scar and breast aesthetics were compared between the two groups. Results The scores of VSS, OSAS and PSAS in the observation group were lower than those in the control group (P <0.05). The proportion of excellent breast aesthetics in the observation group was higher than that in the control group, and the proportion of good and poor was lower than that in the control group (P <0.05). Conclusion The application of high quality nursing service in breast cancer patients is effective, which is beneficial to dilute the scar of breast incision and improve the aesthetics of breast.