Objective To explore the effect of small incision liposuction surgery+continuous buried suture double eyelid plasty on plastic surgery effect for patients with asymmetric double eyelids. Methods A total of 80 patients who underwent plastic surgery for asymmetric double eyelids at Jinghe Boyu Medical Aesthetic Surgery Clinic from July 2022 to July 2024 were selected as the research subjects, and they were divided into group A and group B according to the random number table method, with 40 patients in each group. Group A received small incision liposuction surgery+conventional incision double eyelid plasty, and group B received small incision liposuction surgery+continuous buried suture double eyelid plasty. The clinical related indicators, plastic surgery effect, adverse reactions and plastic surgery satisfaction were compared between the two groups. Results The operation time and wound recovery time in group B were shorter than those in group A, and the intraoperative blood loss was less than that in group A (P <0.05). The total effective rate of plastic surgery in group B (97.50%) was higher than that in group A (80.00%) (P <0.05). The incidence of adverse reactions in group B (5.00%) was lower than that in group A (20.00%) (P <0.05). The plastic surgery satisfaction of group B (97.50%) was higher than that of group A (85.00%) (P <0.05). Conclusion The treatment of asymmetric double eyelids with small incision liposuction surgery+continuous buried suture double eyelid plasty has a good effect, with less intraoperative blood loss, which is helpful to shorten the operation and recovery time, and has high prognostic safety and patient satisfaction with plastic surgery.