To analyze the effect of midface lifting through external incision approach of eye bag. Methods A total of 100 patients with facial plastic surgery admitted to ZHANG Rui-hong Medical Beauty Clinic from June 2021 to February 2023 were selected and divided into control group and observation group according to the random number table method, with 50 patients in each group. The control group underwent traditional midface lifting, and the observation group underwent midface lifting through external incision approach of eye bag. The clinical efficacy, incidence of complication, negative emotion and aesthetics were compared between the two groups. Results The total effective rate of the observation group was 98.00%, which was higher than 82.00% of the control group (P <0.05). The incidence of complications in the observation group was 2.00%, which was lower than 14.00% in the control group (P <0.05). The scores of SAS and SDS in the observation group were lower than those in the control group (P <0.05). The excellent and good rate of aesthetics in the observation group was 98.00%, which was higher than 78.00% in the control group (P <0.05). Conclusion In the midface lifting surgery, the external incision approach of eye bag can improve the effectiveness and aesthetics of the surgery, improve the patient's negative emotion, and the safety factor is high.