Objective To analyze the effect of double-ring breast plastic surgery on breast appearance aesthetics in patients with breast ptosis. Methods A total of 80 patients with breast ptosis admitted to Department of Plastic Surgery, Dalian Aid BeauCare Clinic Co., Ltd. from November 2023 to November 2025 were selected, and they were divided into the reference group (40 patients) and the study group (40 patients) by the random number table method. The reference group was treated with vertical double-pedicle breast plastic surgery, and the study group was treated with double-ring breast plastic surgery. The plastic effect, breast morphology-related indicators, nipple-areola sensory scores, breast appearance aesthetics and complications were compared between the two groups. Results The excellent and good rate of plastic surgery in the study group (97.50%) was higher than that in the reference group (82.50%) (P<0.05). At 3 months after surgery, the nipple to inframammary fold distance, sternum to nipple distance and clavicle to nipple distance in the study group were shorter than those in the reference group (P<0.05). At 3 months after surgery, the scores of temperature sensation, pain sensation, tactile sensation and sexual sensation in the study group were higher than those in the reference group (P<0.05). At 3 months after surgery, the BREAST-Q score of the study group was higher than that of the reference group (P<0.05). The incidence of complications in the study group was lower than that in the reference group (P<0.05). Conclusion For breast ptosis, double-ring breast plastic surgery can effectively improve the plastic effect and breast morphology, enhance breast appearance aesthetics, with better recovery of nipple-areola sensation and high safety.