Blepharoplasty Alternatives to Reduce Puffy Under Eye Bags? (photo)

Thanks for your question and photographs.  Based on the photos that you've provided and your medical history, I think that your best option is going to be a lower eyelid lift (blepharoplasty).  Many physicians will try to disguise puffy lids by the use of  facial fillers, but this works best when there is a depression below the eyelid.  In your situation, I don't think you would be happy with the result. I would recommend consulting with a board certified plastic surgeon with extensive experience in eyelid surgery for treatment options. Good luck to you.  

First please recognize that you can get excellent care from several types of surgical specialists not just board certified general plastic surgeons.  I am an oculoplastic surgeon and I believe that my speciality offers the greatest depth in the area of eyelid surgery.  However you will find than a variety of specialist offer very good cosmetic eyelid surgery form area including oculoplastic surgery, facial plastic surgery, and yes, general plastic surgery.  

What is the right option for you?  I think a personal consultation is the best way to answer this question.  You do have a type of localized fullness in the lower eyelids that might do very well with a surgery called an arcus marginalis release.  I would strongly advise you against letting anyone perform this through a lower eyelid skin incision.  It is possible to do the surgery from behind the lower eyelid leaving no skin scar.

I also think that you could get amazing resulting with Restylane under eye filler.  The skill of the injector is critical to get the best result.  Since you are young, I would probable encourage you to start with filler and no surgery.

Get several opinions.  Consider see my colleague John McCann in Salt Lake City.