Objective To explore the application advantages and effects of buried guidance technique in eye bag plastic surgery. Methods A total of 60 patients with baggy eye admitted to Nanjing Jiangning Lingmei Oriental Medical Beauty Clinic from January 2018 to January 2023 were selected as the research objects. They were divided into conventional group and experimental group by random number table method, with 30 patients in each group. The conventional group was treated with routine lower eyelid skin approach to carry out eye bag plastic surgery, and the experimental group was treated with buried guidance technique to carry out eye bag plastic surgery. The operation time, eye swelling recovery time, clinical efficacy and satisfaction were compared between the two groups. Results The operation time and recovery time of eye swelling in the experimental group were shorter than those in the conventional group (P <0.05). The total effective rate of treatment in the experimental group was 96.67%, which was higher than 73.33% in the conventional group (P <0.05). The satisfaction of plastic surgery in the experimental group was higher than that in the conventional group (P <0.05). Conclusion The application of buried guidance technique in eye bag plastic surgery has the advantages of light swelling, quick recovery and good effect, and the patient satisfaction is higher, which is worthy of clinical application.