Objective To explore the effect and safety of dermal-fat graft correction surgery in the treatment of severe eye socket depression. Methods From January 2022 to February 2024, 80 patients with severe eye socket depression admitted to Shaanxi Vimmer Big Eyes Medical Beauty Clinic were randomly divided into control group and experimental group, with 40 patients in each group. The control group received autologous fat transplantation, and the experimental group received dermal-fat graft correction surgery. The clinical efficacy, scar condition and complication rate were compared between the two groups. Results There was no significant difference in the total effective rate between the two groups at 1 week and 1 month after operation (P >0.05). The effective rate of treatment in the experimental group was higher than that in the control group at 3 months and 6 months after operation (P <0.05). After treatment, the scores of VSS and SBSES in the experimental group were better than those in the control group (P <0.05). The incidence of graft atrophy, graft necrosis and ptosis in the experimental group were lower than that in the control group (P <0.05). Conclusion Dermal-fat graft correction surgery for the treatment of severe eye socket depression can not only provide better morphological and functional recovery in the short term, but also is superior to traditional autologous fat transplantation in terms of long-term effect and complication rate. It is an effective and safe method.