Abstract: Objective To compare the plastic and conventional breast conserving surgery on the cosmetic effect and survival prognosis of patients with early breast cancer. Methods 80 early breast cancer patients treated with breast conserving surgery in The Fifth People's Hospital of Qinghai Province from January 2015 to July 2019 were selected, and divided into experimental group （n=40） and control group （n=40） according to the random table. The experimental group was treated with plastic breast conserving surgery, and the control group was treated with conventional breast conserving surgery. The perioperative situation, complications, cosmetic effect and survival prognosis of the two groups were compared. Results The operation time, resected tissue / breast volume ratio, minimum distance between tumor and the cutting edge in the experimental group were higher than those in the control group, the intraoperative blood loss, time to remove the drainage tube, postoperative drainage volume and length of hospital stay in the experimental group were lower than those in the control group, the complication rate in the experimental group was lower than that in the control group, and the excellent and good rate of breast cosmetic effect in the experimental group was higher than that in the control group, the difference were all statistically significant （P<0.05）. The Kaplan-Meier curve showed that, the survival rate in the experimental group and control group was basically the same （P>0.05）. Conclusions Compare with conventional breast conserving surgery, plastic breast conserving surgery has the advantages of less invasion, fewer complications and faster recovery, which can improve the cosmetic effect of patients with early breast cancer.