To investigate the cosmetic needs of young and middle-aged breast cancer patients after operation, and to explore the corresponding nursing intervention measures. Methods A total of 100 young and middle-aged patients with breast cancer who were admitted to Houjie Hospital from February 2020 to February 2023 were selected. Data collection and questionnaire survey were conducted on all patients to understand their cosmetic needs, and effective nursing interventions were proposed according to the characteristics of different patients. Results The demand rate of 100 young and middle-aged breast cancer patients after operation was 78.00%, and the demand rate of youth beauty was 100.00%, which was higher than 52.17% of middle-aged (P <0.05). The cosmetic demand rate of junior college degree and above was 96.77%, which was higher than 77.78% and 54.17% of middle school and primary school and below (P <0.05). The beauty demand rate of professional cadres was 100.00%, which was higher than 90.00% and 48.57% of workers and farmers (P <0.05). The cosmetic demand rate of public health care providers was 80.46%, which was compared with 62.50% and 60.00% of other payment methods and self-paid medical care, the difference was not statistically significant (P >0.05). Conclusion The postoperative cosmetic needs of young and middle-aged breast cancer patients are higher, especially those with younger age, professional cadres and higher education level. Therefore, clinical attention should be paid to the corresponding nursing intervention measures to help them reduce negative emotions, improve confidence in life, promote rehabilitation, and make patients return to society faster.