Objective To explore the effect of orbital septum folding combined with flap bag correction in the treatment of patients with middle facial relaxation combined with eye bag. Methods From June 2021 to June 2022, 82 middle-aged and elderly patients with eyelid bag bulging of skin orbicularis oculi muscle relaxation admitted to our hospital were selected as the research objects. They were divided into traditional group and modified group according to the random number table method, with 41 patients in each group. The traditional group was treated with flap bag correction, and the modified group was treated with orbital septum folding combined with flap bag correction. The surgical effects, treatment satisfaction and complications were compared between the two groups. Results The excellent and good rate of treatment in the modified group was 97.56%, which was higher than 85.37% in the traditional group (P <0.05). The treatment satisfaction of the modified group was 92.68%, which was higher than 73.17% of the traditional group (P <0.05). The incidence of complications in the modified group was 2.44%, which was lower than 14.63% in the traditional group (P <0.05). Conclusion The effect of orbital septum folding combined with flap blepharoplasty in the treatment of middle-aged and elderly patients with eyelid bag bulging of skin orbicularis oculi muscle relaxation is good, and the incidence of adverse reactions after treatment is low, and the patient satisfaction is high, which is worthy of clinical application.