Puffy upper eyelids, inner corner. What would you recommend? (Photo)

good morning!Photos are always difficult to give a definitive answer in eyelid surgery, but you would benefit from a blepharoplasty with removal of the medial fat pad.  It is a simple operation that in my practice is often performed under local anesthesia if the patient prefers.  Recovery is quick with minimal bruising.Be sure you are seeing a board certified plastic surgeon well versed in these procedures before proceeding.I hope this helps

Puffiness at the inner corner of the upper eyelids is very common, and tends to worsen with age. While allergies and weight loss may contribute to this problem, this is most commonly a genetic issue. The puffiness in this area is usually due to bulging of the fatty tissue that cushions the eye. A conservative upper lid blepharoplasty with fat removal can often be helpful to remove a little bit of excess skin and fatty tissue under the skin. In some cases, a brow lift may be needed instead of (or in addition to) eyelid surgery in order to decrease excess heaviness of the upper eyelid area, but this is difficult to determine based on the photos provided. 
As a non-surgical option, laser skin resurfacing of the upper eyelid area can provide a mild amount of improvement and tightening as well, but is unlikely to provide enough improvement for patients to be completely satisfied.
Be sure to see a surgeon who specializes in facial aesthetic procedures to review all of the options in detail.
All the best,