Objective To analyze the effect of local flap treatment on incision healing and eyelid function recovery in patients undergoing periocular cosmetic plastic surgery. Methods A total of 48 patients who underwent periocular cosmetic plastic surgery at Xingyi People's Hospital from January 2023 to January 2025 were selected as the research subjects. According to different treatment methods, they were divided into the control group (n =24) and the experimental group (n =24). The control group received flap transplantation, and the experimental group received local flap treatment. The incision healing, eyelid function recovery and complications were compared between the two groups. Results The excellent and good rate of healing in the experimental group (91.67%) was higher than that in the control group (58.33%) (P <0.05). The total effective rate of eyelid function recovery in the experimental group (95.83%) was higher than that in the control group (83.33%) (P <0.05). The incidence of complications in the experimental group (4.17%) was lower than that in the control group (25.00%) (P <0.05). Conclusion Local flap treatment in periocular cosmetic plastic surgery can improve the excellent and good rate of incision healing, effectively promote eyelid function recovery, and has a low incidence of postoperative complications and high treatment safety, which is worthy of clinical application.