30 yr old with asymmetrical under eye bags (Photo)

Whenever I'm consulting with a new patient I'll often remind them that the two sides of the face are sisters not twins. It's not uncommon for the anatomy on one side of the face to be slightly different than the other side. Based off the two pictures shown and the fact you've had this since you were young, I'd recommend a lower lid blepharoplasty with fat grafting. Both sides have shadowing from prolapse of the fat pads around the eyes. The soft tissue of the cheek on the left side is not as full as it is on the right side which makes the fat prolapse on this side more visible. Filler may improve this symmetry, but filler around the eyes can encapsulate and cause swelling. I usually don't recommend filler in this area if you are considering surgery. I'd recommend making an appointment with a local Facial Plastic Surgeon, Oculoplastic Surgeon, or Plastic Surgeon in your area who specializes in this procedure.

Good morning and happy holidays!
I can understand how this can be a frustrating situation. There are different options for you in terms of improving symmetry and reducing the appearance of the puffiness in the lower eyelids. As you want a permanent solution, a surgical option may give you the longest lasting results. Your concerns may be addressed by performing a transconjunctival (scarless) lower eyelid blepharoplasty to excise or reposition the lower eyelid fat. There are other non surgical options including filler, but these may not be as long lasting and also carry other complications.
I hope this helps!