Objective To explore the effect of psychological nursing based on empathy concept combined with aesthetic nursing in patients undergoing double eyelid surgery combined with lower blepharoplasty. Methods A total of 62 patients who received double eyelid surgery combined with lower blepharoplasty in our hospital from January 2023 to December 2024 were selected as the research subjects, and they were divided into the control group (n=31) and the study group (n=31) by the random number table method. The control group received conventional perioperative nursing, and the study group received psychological nursing based on empathy concept combined with aesthetic nursing on the basis of the control group. The anxiety state, pain degree and satisfaction were compared between the two groups. Results After intervention, the scores of state anxiety, trait factors, surgical anesthesia factors and postoperative recovery factors in the two groups were lower than those before intervention, and those in the study group were lower than those in the control group (P<0.05). After intervention, the scores of resting pain and active pain in the two groups were lower than those before intervention, and those in the study group were lower than those in the control group (P<0.05). The satisfaction scores of general hospitalization service, treatment service and discharge guidance and total satisfaction scores in the study group were higher than those in the control group (P<0.05). Conclusion Psychological nursing based on empathy concept combined with aesthetic nursing can improve the psychological state of patients undergoing double eyelid surgery combined with lower blepharoplasty, relieve their postoperative pain, and help to improve patient satisfaction.