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I was thinking it might be altering an original versus modifying a method and creating something new, but it doesn't really work out: it seems both can be used for either. I don't see any difference. Are they exact/perfect synonyms?

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    The words are used in different contexts. What is your context exactly? They have different usages in various contexts. It's hard to specify everyone. Alterations of men's suits [not modifications]; modifications to architectural drawing or a project, i.e. changes. Context rules here. – Lambie Jan 31 '18 at 22:28
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    When you say "it seems both can be used for either," could you give some examples? Without more context it's difficult to understand your confusion. – Andrew Feb 1 '18 at 1:48
  • @Lambie I didn't know there were rules of which to use when, e.g. I didn't know one couldn't say "modifying men's suits". How does one know when to use which, or is it just memorization case-by-case? (This might be nice to put into an answer!) – Luc Feb 1 '18 at 12:41
  • @Luc It's contextual. In tailoring, it's alter and alterations, never modification. With drugs: mind-altering drugs. For car racing, modified engines. For computer programs, modified programs. For contracts: modifications. And so on and so forth. For menus (food): changes. And so one and so forth. This kind of usage takes time to absorb; in some cases, any of the three can be used and in others only one or two of them. Designs (engineering), alterations. Also, if French is your mother tongue, there are similar differences. – Lambie Feb 1 '18 at 15:03
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Some of the comments notwithstanding, these are in fact synonyms, both with the meaning of "change." If you look up either word in a thesaurus, you will find the other listed as a synonym.

However, as with most synonyms, they do have a different shade of meaning, and there are some idiomatic phrases which exclusively use one or the other. As Lambie mentions, making alterations to clothes means sewing (or re-sewing) them to fit a particular person. For example, if you gain weight and have your clothes let out, that is an alteration. (If you lose weight, you would have your clothes taken in, which is also an alteration.)

Modification is generally a rather smaller change than alteration. For example, a modification to a will implies a rather smaller change than an alteration:

George altered his will to disinherit his oldest son.
George modified his will to leave his car to his niece.

As one of the dictionary definitions says:

to change somewhat the form or qualities of; alter partially; amend: to modify a contract.

It is for this reason that we would more often speak of incremental modifications to something rather than incremental alterations, and we would more often (although not as much more often) speak of wholesale alterations of something than wholesale modifications. But there are plenty of situations in which the degree of change isn't important where the words are interchangeable. For example, these sentences have pretty much the same meaning:

We changed our plans for the evening.
We modified our plans for the evening.
We altered our plans for the evening.

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