Objective To analyze the effect of endoscope-assisted dual-plane breast augmentation with implants on aesthetic effect3 and pain intensity. Methods A total of 120 patients who underwent breast augmentation with implants in our hospital from January 2022 to December 2023 were selected as the research subjects, and they were divided into the control group (n=60) and the observation group (n=60) according to different surgical methods. The control group underwent conventional blind breast augmentation with implants, and the observation group underwent endoscope-assisted dual-plane breast augmentation with implants. The breast aesthetic effect, pain intensity and complications were compared between the two groups. Results The excellent and good rate of postoperative breast aesthetic effect in the observation group was 96.67%, which was higher than 83.33% in the control group (P<0.05). The scores of VAS in the observation group at 24, 48 and 72 h after operation were lower than those in the control group (P<0.05). The incidence of postoperative complications in the observation group was 5.00%, which was lower than 18.33% in the control group (P<0.05). Conclusion Compared with conventional breast augmentation with implants, endoscope-assisted dual-plane breast augmentation with implants can effectively improve postoperative breast aesthetic effect, reduce the incidence of complications, and alleviate postoperative pain intensity, which is worthy of clinical application.