Objective To explore the clinical effect of small-incision liposuction combined with continuous buried suture double eyelid surgery in ptosis plastic surgery. Methods A total of 100 patients with mild to moderate ptosis admitted to Yantai Sogood Medical Cosmetology Hospital from March 2022 to March 2025 were selected. According to the random number table method, they were divided into group A and group B, with 50 patients in each group. Group A was treated with conventional incisional double eyelid surgery, and group B was treated with small-incision liposuction combined with continuous buried suture double eyelid surgery. The surgical related indicators, satisfaction and complication rate were compared between the two groups. Results The operation time, incision healing time and intraoperative blood loss in group B were better than those in group A (P<0.05). The satisfaction rate of group B was 96.00%, which was higher than 78.00% of group A (P<0.05). The incidence of complications in group B was 6.00%, which was lower than 22.00% in group A (P<0.05). Conclusion Small-incision liposuction combined with continuous buried suture double eyelid surgery has a deffnite clinical effect in ptosis plastic surgery. It can effectively optimize the surgical related indicators of patients with mild to moderate ptosis, reduce the risk of postoperative complications, and improve satisfaction.