To analyze the clinical effect of bi-planar eye bag revision with retention of lying silkworms in the treatment of eye bag. Methods A total of 106 patients with eye bag admitted to the Department of Plastic Surgery, Nantong Kangmei Plastic Surgery Hospital from June 2022 to June 2023 were selected as the study subjects, and were divided into the traditional group and the new groupby using the method of randomized numerical table, with 53 in each group. The traditional group was treated with traditional eye bag revision surgery, and the new group was treated with biplane eye bag revision surgery with retention of lying silkworms.The clinical efficacy, satisfaction, complications and the proportion of retained exposed lying silkworm were compared between the two groups. Results The total effective rate of the new group was higher than that of the traditional group (P <0.05). The satisfaction rate of the new group was higher than that of the traditional group (P <0.05). The incidence of postoperative complications in the new group was lower than that in the traditional group (P <0.05).The proportion of retained exposed lyingsilkworm in the new group was 81.13%, which was higher than 20.75% of the traditional group (P <0.05). Conclusion Biplane eye bag revision with retention of lying silkworms is more effective in patients with eye bag, improves patient satisfaction, and has higher safety, which is worthy of clinical application.