Objective To analyze the effect of breast-conserving surgery combined with breast plastic surgery on postoperative breast aesthetics and complications in breast cancer patients. Methods A total of 52 breast cancer patients admitted to People’s Hospital of Honghuagang District from March 2021 to August 2024 were selected as the research subjects. According to the random number table method, they were divided into the reference group and the experimental group, with 26 patients in each group. The reference group underwent breast-conserving surgery, and the experimental group underwent breast-conserving surgery combined with breast plastic surgery. The postoperative breast aesthetics, complications and tube removal time were compared between the two groups. Results The postoperative breast aesthetics in the experimental group (88.46%) was higher than that in the reference group (53.85%) (P <0.05). There was no significant difference in the incidence of complications between the two groups (P >0.05). There were no significant differences in the axillary drain removal time and breast drain removal time between the two groups (P >0.05). Conclusion The application of breast-conserving surgery combined with breast plastic surgery in breast cancer patients can effectively improve the postoperative breast aesthetics, without increasing the risk of complications or affecting the tube removal time. It is worthy of clinical application.