Objective To investigate the clinical effect of small incision degreasing+continuous embedding double eyelid surgery in patients with asymmetric double eyelid plastic surgery. Methods A total of 60 patients with asymmetric double eyelid plastic surgery admitted to our hospital from March 2022 to February 2024 were randomly divided into reference group and study group, with 30 patients in each group. The reference group selected traditional incision repair, and the study group selected small incision degreasing+continuous embedding double eyelid repair. The clinical efficacy, clinical surgical indicators, treatment satisfaction, adverse reactions and aesthetics of the two groups were compared. Results The total effective rate of treatment in the study group was 96.67%, which was higher than 73.33% in the reference group, the difference was statistically significant (P <0.05). The intraoperative blood loss in the study group was less than that in the reference group, and the operation time and incision healing time were shorter than those in the reference group, the differences were statistically significant (P <0.05). The treatment satisfaction of the study group (96.67%) was higher than that of the reference group (73.33%), and the difference was statistically significant (P <0.05). The incidence of adverse reactions in the study group (3.33%) was lower than that in the reference group (30.00%), and the difference was statistically significant (P <0.05). The aesthetic score of the study group was higher than that of the reference group, and the difference was statistically significant (P <0.05). Conclusion The clinical application of small incision degreasing+continuous embedding double eyelid surgery to repair asymmetric double eyelid plastic surgery can improve the surgical effect and safety, reduce intraoperative blood loss, shorten the operation time and incision healing time, and obtain higher satisfaction and aesthetics.