Objective To explore the effect of continuous buried suture+small incision liposuction plastic surgery on pain level and quality of life in patients with congenital asymmetric double eyelids. Methods A total of 78 patients with congenital asymmetric double eyelids admitted to Quzhou Qujiang Fanxing Medical Aesthetic Clinic from January to December 2023 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 39 patients in each group. The control group received traditional incision repair surgery, and the observation group received continuous buried suture+small incision liposuction plastic surgery. The clinical indexes, clinical efficacy, pain level, quality of life and complications were compared between the two groups. Results The operation time and healing time in the observation 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 clinical effective rate in the observation group was 97.44%, which was higher than 79.49% in the control group (P<0.05). The pain scores at 1, 2, and 3 hours after surgery in the observation group were all lower than those in the control group (P<0.05). After intervention, the scores of various aspects of quality of life in the observation group were higher than those in the control group (P<0.05). The incidence of complications in the observation group was 2.56%, which was lower than 17.95% in the control group (P<0.05). Conclusion In the plastic surgery for congenital asymmetric double eyelids, the method of continuous buried suture+small incision liposuction plastic surgery can obtain satisfactory intervention effect. The pain level of patients is low, and it is beneficial to improving the quality of life of patients, with few adverse reactions, which is worthy of application.