Recently developed prominent bag under one eye - filler, or is blepharoplasty the only way? (Photo)

You have some puffiness under both eyes, but it is worse on one than the other. This issue is caused by fat that is protruding under the skin. Lower eyelid surgery could be done to directly address this protruding fat and would produce the longest lasting results. It is possible that a filler could be used to be placed under the puffy area to try and camouflage it. This would be the non-surgical option.

The bag represents fat bulging. Adding fat to the depression below tne fat bulge will help but the best result Woukd be to remove some fat combined with fat transfer. Fat rearrangement through a blepharoplasty approach also works but in my hands is less predictable with a longer recovery.