Objective To analyze the effect of different blepharoplasties combined with small incision liposuction on plastic effects in patients with asymmetric double eyelid. Methods A total of 88 patients with asymmetric double eyelid admitted to Plastic Surgery Department of Nantong Chunshushang Medical Beauty Clinic from October 2022 to June 2024 were selected as the research subjects, and they were randomly divided into control group and study group, with 44 patients in each group. The control group was treated with conventional incision blepharoplasty combined with small incision liposuction, and the study group was treated with continuous buried suture blepharoplasty combined with small incision liposuction. The clinical related indexes, clinical efficacy, patient satisfaction and complication rate were compared between the two groups. Results The operation time and wound healing time in the study group were shorter than those in the control group, and the intraoperative blood loss was less than that in the control group (P <0.05). The total effective rate of treatment in the study group (95.45%) was higher than that in the control group (81.82%) (P <0.05). The patient satisfaction in the study group (93.18%) was higher than that in the control group (77.27%) (P <0.05). The incidence of complications in the study group (4.55%) was lower than that in the control group (18.18%) (P <0.05). Conclusion The effect of continuous buried suture blepharoplasty combined with small incision liposuction in the plastic surgery treatment of patients with asymmetric double eyelid is better, with less trauma, faster postoperative recovery and fewer postoperative complications, while patients are more satisfied with the restoration effect.