Objective To explore the effect of aesthetic tension reduction nursing on scar status and scar repair effect after breast-conserving surgery for breast cancer. Methods A total of 82 breast cancer patients who received breast-conserving surgery at General Hospital of Ningxia Medical University from April 2023 to January 2026 were selected. According to the random number table method, they were divided into the control group and the study group, with 41 patients in each group. The control group received conventional scar nursing, and the study group received aesthetic tension reduction nursing. The scar status, scar repair effect, scar width, satisfaction and negative emotions were compared between the two groups. Results The VSS score of the two groups after intervention was lower than that before intervention, and that of the study group was lower than that of the control group (P <0.05). The total effective rate of scar repair in the study group (97.56%) was higher than that in the control group (78.05%) (P <0.05). The scar width of the study group was (0.36±0.11)cm at 6 months after operation, which was narrower than (0.89±0.17)cm of the control group (P <0.05). The satisfaction rate of the study group (100.00%) was higher than that of the control group (80.49%) (P <0.05). After intervention, the scores of SAS and SDS in the two groups were lower than those before intervention, and those in the study group were lower than those in the control group (P <0.05). Conclusion For breast cancer patients undergoing breast-conserving surgery, the application of aesthetic tension reduction nursing can effectively improve postoperative scar status, promote scar repair effect, and narrow scar width. It is conducive to improving patient satisfaction and relieving anxiety and depression.