Objective To analyze the effect of specialized nursing combined with health education intervention on breast surface aesthetics in patients after mastectomy. Methods A total of 66 patients who underwent mastectomy in the Department of General Surgery, Shanghai Yangpu Shidong Hospital from June 2025 to January 2026 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 33 patients in each group. The control group received conventional nursing, and the observation group received specialized nursing combined with health education intervention on the basis of the control group. The breast surface aesthetics, nursing satisfaction and self-efffcacy were compared between the two groups. Results At 1 month after operation, the scores of breast shape, incision scar, pigmentation and areola sensation in the observation group were higher than those in the control group (P<0.05). The nursing satisfaction rate of the observation group (96.97%) was higher than that of the control group (72.73%) (P<0.05). At 1 month after operation, the self-efficacy score of the observation group was higher than that of the control group (P<0.05). Conclusion The application of specialized nursing combined with health education intervention for patients after mastectomy can not only improve breast aesthetics, but also enhance patients' self-efffcacy and further increase nursing satisfaction.