Objective: To explore and evaluate the clinical efficacy of using continuous suture-based double eyelid reconstruction and small incision liposuction combined therapy in the repair of asymmetrical double eyelids. Methods: The research subjects were 88 patients with asymmetrical double eyelids who were included from February 2025 to February 2026. The study was divided into groups based on different surgical plans. 44 patients in each group. The control group received conventional incision treatment, while the experimental group received continuous suture-based double eyelid reconstruction and small incision liposuction combined therapy. The cosmetic effects of the two groups were compared. Results: Through calculation, it was found that the clinical treatment effective rate of the experimental group (97.73%) was higher than that of the control group (79.55%), P < 0.05; the operation time and healing time of the experimental group were shorter than those of the control group, and the intraoperative bleeding volume was less, P < 0.05; compared with the control group, the complication rate of the experimental group was lower, P < 0.05. Conclusion: The use of continuous suture-based double eyelid reconstruction and small incision liposuction combined therapy in the repair of asymmetrical double eyelids can not only reduce the intraoperative bleeding volume and complication rate to a certain extent, but also shorten the operation time and healing time, and improve the treatment effect.