Objective To analyze the effect of modified epicanthus correction surgery combined with double eyelid surgery on periocular aesthetics of patients. Methods A total of 260 patients who received double eyelid surgery combined with epicanthus correction in Xuzhou Shining Cosmetology Hospital from January 2024 to January 2025 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 130 patients in each group. All patients underwent incision double eyelid surgery, and they received different epicanthus correction surgeries at the same time. The control group was treated with traditional epicanthoplasty, and the observation group was treated with modified epicanthus correction surgery. The periocular aesthetics, satisfaction, adverse reaction rate and recurrence rate were compared between the two groups. Results After operation, the intercanthal distance in the observation group was lower than that in the control group, and the length and vertical height of the palpebral fissure were higher than those in the control group (P <0.05). The satisfaction rate of the observation group was 88.46%, which was higher than 73.85% of the control group (P <0.05). The incidence of adverse reactions in the observation group was 6.15%, which was lower than 13.85% in the control group (P <0.05). The recurrence rate of epicanthal fold in the observation group was lower than that in the control group (P <0.05). Conclusion Modified epicanthus correction surgery combined with double eyelid surgery has a good cosmetic effect after operation. It can improve the ocular aesthetic shape of patients, effectively shorten the intercanthal distance, increase the length and height of the palpebral fissure, enhance patient satisfaction, and reduce the incidence of adverse reactions and postoperative recurrence rate, which is worthy of clinical application.