To study the clinical effect of small incision degreasing combined with continuous embedding double eyelid surgery in asymmetric double eyelid plastic surgery. Methods A total of 84 patients with asymmetric double eyelid plastic surgery admitted to the Second Affiliated Hospital of Guizhou Medical University from March 2022 to March 2023 were selected as the research objects. They were randomly divided into experimental group and reference group, with 42 patients in each group. The reference group was treated with simple embedding double eyelid plastic surgery, and the experimental group was treated with small incision degreasing combined with continuous embedding double eyelid plastic surgery. The clinical effects, surgical related indicators and complications were compared between the two groups. Results The total effective rate of the experimental group was 97.62%, which was higher than 71.43% of the reference group, and the difference was statistically significant (P <0.05). The operation time, wound size, wound number, bleeding volume and wound healing time of the experimental group were better than those of the reference group, and the differences were statistically significant (P <0.05). The incidence of complications in the experimental group was 7.14%, which was lower than 38.10% in the reference group, and the difference was statistically significant (P <0.05). Conclusion The clinical effect of small incision degreasing combined with continuous embedding double eyelid surgery in asymmetric double eyelid plastic surgery is ideal, which can reduce the operation time and intraoperative blood loss, and the incidence of complications is small, the wound recovery speed is fast, and the operation safety is high.