Objective To explore the effect of continuous embedding double eyelid plasty combined with small-incision liposuction on eyelid scar formation in patients with asymmetric double eyelids. Methods A total of 88 patients with asymmetric double eyelids admitted to Anji County Changshuo Street Health Service Center from February 2025 to February 2026 were selected as the research subjects, and they were divided into group A and group B according to different surgical schemes, with 44 patients in each group. Group A received conventional incision double eyelid plasty, and group B received continuous embedding double eyelid plasty combined with small-incision liposuction. The clinical efficacy, clinical related indicators, eyelid scar formation and complication rate were compared between the two groups. Results The total effective rate of group B (97.73%) was higher than that of group A (79.55%) (P<0.05). The operation time and healing time of group B were shorter than those of group A, and the intraoperative blood loss of group B was less than that of group A (P<0.05). After treatment, the scores of scar thickness, color, softness and vascular distribution in group B were lower than those in group A (P<0.05). The incidence of complications in group B (4.55%) was lower than that in group A (18.18%) (P<0.05). Conclusion For the correction of asymmetric double eyelids, the combined regimen of continuous embedding double eyelid plasty and small-incision liposuction can effectively reduce intraoperative blood loss and complication rate, shorten operation and healing time, inhibit eyelid scar formation, and further improve the overall therapeutic effect.