Objective To explore the effect of double eyelid plasty combined with lacrimal gland reduction in plastic surgery of blepharochalasis. Methods A total of 90 patients with blepharochalasis admitted to our hospital from January to December 2020 were divided into control group and observation group by random number toble method, with 45 cases in each group. The control group was treated with double eyelid plasty, and the observation group was treated with double eyelid plasty combined with lacrimal gland reduction. The clinical efficacy, hospitalization time, recovery time of eye appearance, cosmetic effect, postoperative scar and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was 95.56%, which was higher than 82.22% of the control group (P<0.05). The hospitalization time and the recovery time of eye appearance in the observation group were shorter than those in the control group (P<0.05). The scores of orbital relaxation and wrinkles in the observation group were better than those in the control group at 6 months after operation (P<0.05). The scar scores of the observation groups at 1 week and 6 months after operation were lower than those of the control group, but the differences were not statistically significant (P>0.05). The incidence of adverse reactions in the observation group was 6.67%, which was lower than 8.89% in the control group, but the differences were not statistically significant (P>0.05). Conclusion The application of double eyelid plasty combined with lacrimal gland reduction in the plastic surgery of blepharochalasis has a good effect and excellent cosmetic effect, which can effectively improve the orbital relaxation and wrinkles, shorten the recovery time, and has fewer adverse reactions and higher safety.