Can this noticeable crease/pucker be fixed via eyelid revision? (Photo)

Hi there! I agree that fat removal was a good direction to take as that fat pad can protrude and cause fullness. Since there's unevenness, more skin excision may be needed to smooth the overall appearance. This can be done similar to your prior blepharoplasty via a skin pinch. I think realistically you can expect improvement though the symmetry may not be the same as the left side. Hope this helps!