Objective To explore the application effect of precision specialized nursing combined with supportive psychological intervention in patients after mastectomy and its inffuence on breast surface aesthetics. Methods A total of 66 patients undergoing mastectomy who were admitted to the Department of General Surgery, Shidong Hospital, Yangpu District from July 2025 to February 2026 were selected as the research subjects. According to the random number table method, they were divided into group A and group B, with 33 patients in each group. Group A received conventional nursing, and group B received precision specialized nursing combined with supportive psychological intervention on the basis of conventional nursing. The scar healing, breast surface aesthetics, nursing satisfaction and incision healing were compared between the two groups. Results At 1 month after nursing, the VSS score of group B was lower than that of group A (P<0.05). At 1 month after nursing, the scores of breast shape, incision scar, pigmentation and areola sensation in group B were higher than those in group A (P<0.05). The nursing satisfaction of group B (93.94%) was higher than that of group A (72.73%) (P<0.05). The grade A incision healing rate in group B (57.58%) was higher than that in group A (33.33%) (P<0.05). Conclusion The application of precision specialized nursing combined with supportive psychological intervention for patients after mastectomy can improve their nursing satisfaction, promote incision healing, optimize breast surface aesthetics, and improve scar healing effect.