Objective To explore the effect of modiffed blepharoplasty on cosmetic effect and upper eyelid function improvement in patients with foldless eyelid combined with mild ptosis. Methods A total of 50 patients with foldless eyelid combined with mild ptosis admitted to Eye Hospital of Yaodu District from January 2024 to January 2026 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 25 patients in each group. The control group was treated with conventional blepharoplasty, and the observation group was treated with modiffed blepharoplasty. The cosmetic effect, cosmetic satisfaction, upper eyelid function improvement and complication rate were compared between the two groups. Results The scores of naturalness of upper eyelid shape, bilateral symmetry, smoothness of double eyelid line and total cosmetic effect score in the observation group after operation were higher than those in the control group (P<0.05). The scores of all cosmetic satisfaction indicators and total score in the observation group after operation were higher than those in the control group (P<0.05). The upper eyelid function improvement score of the observation group after operation was higher than that of the control group (P<0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). Conclusion For patients with foldless eyelid combined with mild ptosis, modified blepharoplasty can not only effectively improve upper eyelid function, but also achieve better cosmetic effect, with higher patient cosmetic satisfaction. This surgery has good safety.