Objective To analyze the application effect of small incision liposuction and catgut embedding in patients with asymmetric double eyelids. Methods Sixty patients with asymmetric double eyelids admitted to our hospital from January 2021 to December 2023 were selected as the research objects. According to different treatment methods, they were divided into control group and observation group, with 30 patients in each group. The control group was treated with conventional incision, and the observation group was treated with small incision liposuction and catgut embedding. The aesthetic effect satisfaction, complications, postoperative indicators and pain degree were compared between the two groups. Results The satisfaction rate of aesthetic effect in the observation group was 93.33%, which was higher than 70.00% in the control group (P <0.05). The incidence of complications in the observation group was 6.67%, which was lower than 30.00% in the control group (P <0.05). The operation time and wound healing time of the observation group were shorter than those of the control group, and the intraoperative blood loss was less than that of the control group (P <0.05). The pain score of the observation group was lower than that of the control group (P <0.05). Conclusion The clinical effect of small incision liposuction and catgut embedding in the treatment of asymmetric double eyelid is good, which can effectively improve the satisfaction of aesthetic effect, shorten the operation time, reduce the amount of intraoperative blood loss, accelerate wound healing, reduce pain, and have low risk of postoperative complications and high safety.