Objective To analyze the effect of topical application of medical silicone gel on the early improvement of scar after eyelid surgery. Methods A total of 60 patients with early-stage scar after eyelid surgery (including double eyelid surgery, epicanthoplasty, etc.) admitted to the Department of Burn and plastic surgery, Peking University First Hospital from February to October 2024 were selected. According to the random number table method, they were divided into the control group and the experimental group, with 30 patients in each group. The control group received local intervention with conventional moisturizing, and the experimental group received topical application of medical silicone gel. The scar improvement effect, clinical efficacy, patient satisfaction and adverse reactions were compared between the two groups. Results At 1, 3 and 6 months after treatment, the scores of VSS in the experimental group were lower than those in the control group (P <0.05). The total effective rate of the experimental group was 93.33%, which was higher than 66.67% of the control group (P <0.05). The score of VAS in the experimental group at 6 months after treatment was higher than that in the control group (P <0.05). The incidence of adverse reactions in the experimental group was 6.67%, which was higher than 3.33% in the control group, but the difference was not statistically significant (P >0.05). Conclusion Topical application of medical silicone gel can improve the color, thickness, softness and vascular distribution of scar after eyelid surgery, enhance clinical efficacy and patient satisfaction, with mild adverse reactions and good safety, which is worthy of clinical application.