Objective To study the effect of small incision liposuction combined with continuous embedding double eyelid plasty in patients with asymmetric double eyelids. Methods A total of 86 patients with asymmetric double eyelids admitted to Guangdong Hanfei Plastic Surgery Hospital from January 2024 to January 2025 were selected and divided into group A (n=43) and group B (n =43) according to the random number table method. Group A was treated with conventional incision double eyelid plasty, and group B was treated with small incision liposuction combined with continuous embedding double eyelid plasty. The surgical indexes, pain, satisfaction, complication rate and negative emotions were compared between the two groups. Results The surgical indexes of group B were better than those of group A (P <0.05). The VAS scores at 1, 2, and 3 hours in group B after operation were lower than those in group A (P <0.05). The satisfaction of group B (97.67%) was higher than that of group A (79.07%) (P <0.05). The incidence of complications in group B was lower than that in group A (P <0.05). The scores of SAS and SDS in group B after operation were lower than those in group A (P<0.05). Conclusion For patients with asymmetric double eyelids, treatment with small incision liposuction combined with continuous embedding double eyelid plasty can effectively reduce pain, lower the incidence of complications, improve surgical indexes and negative emotions, and play a positive role in improving patient satisfaction.