Objective To analyze the application effect of small-incision liposuction combined with continuous embedding double eyelid surgery in plastic repair of asymmetric double eyelids and its influence on patients' inflammatory response. Methods A total of 62 patients with asymmetric double eyelids admitted to our hospital from January 2023 to December 2025 were selected as the research subjects, and they were divided into the reference group and the experimental group according to different surgical treatment schemes, with 31 patients in each group. The reference group received incisional double eyelid surgery, and the experimental group received small-incision liposuction combined with continuous embedding double eyelid surgery. The operationrelated indicators, pain intensity, inflammatory response, treatment effect and complication rate were compared between the two groups. Results The intraoperative blood loss in the experimental group was less than that in the reference group, the operation time was longer than that in the reference group, the incision healing time was shorter than that in the reference group, and the pain scores at different postoperative time points were lower than those in the reference group (P<0.05). The levels of IL-6, CRP and TNF-α in the two groups at 3 days postoperatively were higher than those before operation, and those in the experimental group at 3 days postoperatively were lower than those in the reference group (P<0.05). The total effective rate of the experimental group (96.77%) was higher than that of the reference group (77.42%) (P<0.05). The incidence of complications in the experimental group was lower than that in the reference group (P <0.05). Conclusion For the treatment of asymmetric double eyelids, small-incision liposuction combined with continuous embedding double eyelid surgery can effectively improve therapeutic efficacy, relieve postoperative pain, reduce inflammatory response and the risk of related complications, promote incision healing, reduce intraoperative blood loss, but prolong the operation time.