Objective To analyze the intervention effect of orbital myofascial tightening combined with orbicularis oculi muscle suspension in cosmetic plastic surgery. Methods A total of 100 patients who underwent eye bag plastic surgery in our hospital from January 2023 to January 2024 were selected as the research objects. According to different plastic surgery methods, they were divided into control group and observation group, with 50 patients in each group. The control group was treated with orbicularis oculi muscle suspension for eye bag plastic surgery, and the observation group was treated with orbital muscle fascia tightening combined with orbicularis oculi muscle suspension for eye bag plastic surgery. The plastic effect, complications and plastic satisfaction of the two groups were compared. Results The total effective rate of the observation group was 98.00%, which was higher than 80.00% of the control group, and the difference was statistically significant,the difference was statistically significant (P <0.05). The incidence of complications in the observation group was 6.00%, which was lower than 20.00% in the control group,the difference was statistically significant (P <0.05). The plastic satisfaction of the observation group was 96.00%, which was higher than 82.00% of the control group, and the difference was statistically significant,the difference was statistically significant (P <0.05). Conclusion The plastic effect of orbital fascia tightening combined with orbicularis oculi muscle suspension eye bag is good, which can effectively improve the eye bag situation, improve the eye aesthetics, and is conducive to the realization of eye rejuvenation. Meanwhile, the incidence of postoperative complications is low, the safety is high, and the patients are satisfied with the plastic effect.