Objective To analyze the application effect of modified pouch plastic surgery in lower eyelid rejuvenation. Methods From September 2022 to September 2023, 68 patients who underwent lower eyelid rejuvenation treatment in Huadian Feiyang Medical Beauty Clinic were selected as the research objects. They were randomly divided into control group and observation group, with 34 patient in each group. The control group was treated with routine blepharoplasty, and the observation group was treated with modified pouch plastic surgery. The clinical efficacy, complications and satisfaction of the two groups were compared. Results The total effective rate of the observation group was 97.06%, which was higher than 82.35% of the control group, and the difference was statistically significant (P <0.05). The incidence of postoperative complications in the observation group was 2.94%, which was lower than 20.59% in the control group, and the difference was statistically significant (P <0.05). The satisfaction rate of the observation group was 94.12%, which was higher than 76.47% of the control group, and the difference was statistically significant (P <0.05). Conclusion The application of modified pouch plastic surgery in lower eyelid rejuvenation is beneficial to improve the symptoms of eye bag relaxation, ptosis, bulging and lacrimal groove, improve the aesthetic degree of facial morphology, reduce postoperative complications, and improve patient satisfaction.