Objective To explore the clinical effect of modified myocutaneous flap+orbital septum fixation in eye bag plastic surgery. Methods A total of 100 patients who underwent eye bag plastic surgery in our hospital from April 2022 to February 2023 were randomly divided into control group and observation group, with 50 patients in each group. The control group was treated with traditional myocutaneous flap method, and the observation group was treated with modified myocutaneous flap method+orbital septum fixation. The clinical efficacy, the recovery time of the skin appearance of the eye bag and the incidence of complications were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant ( P <0.05). The incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant ( P <0.05). The recovery time of eye bag skin appearance in the observation group was shorter than that in the control group, and the difference was statistically significant ( P <0.05). Conclusion The application of modified myocutaneous flap+orbital septum fixation in eye bag plastic surgery has ideal effect, with shorter recovery time and lower incidence of postoperative complications.