Objective To observe the effect of orbicularis oculi muscle tightening under bipolar electrocoagulation for pouch plastic surgery. Methods A total of 110 patients who underwent pouch plastic surgery in our hospital from January 2021 to August 2021 were selected as observation objects. According to the digital random table method, they were divided into the conventional group and the study group, with 55 cases in each group. The conventional group underwent traditional pouch resection, and the study group underwent orbicularis oculi muscle tightening under bipolar electrocoagulation. The operation effect, treatment satisfaction, eye symptom score, complication rate and quality of life score were compared between the two groups. Results The scores of surgical efficacy, satisfaction and quality of life in the study group were higher than those in the conventional group, and the scores of eye irritation, photophobia and foreign body sensation were lower than those in the conventional group (P＜0.05). There was no significant difference in the incidence of complications between the two groups (P＞0.05). Conclusion Orbicularis oculi muscle tightening under bipolar electrocoagulation is reliable, efficient and safe, which can reduce the adverse effects on the eyes of patients, improve the plastic satisfaction and the quality of life of patients.