Combination therapy would probably be best. You have active acne which should be treated. It is unclear if you have ever used Accutane, but that would be something to consider. Regarding the past scarring, a fractionated destructive CO2 laser approach would be applicable as well as radiofrequency needling. Your board certified dermatologist should have some insight into your specific needs. Good luck.
The first photo demonstrates the movement issue that you are describing, but the other two photographs are not clear as to where the surgery was performed. To answer your question about permanence of this issue, I would suggest that you approach the surgeon who performed the surgery and who had placed the sutures. They can properly evaluate any deficit that you may have and provide insight into your question.
Depending on the filler product utilized, with time, the impact of your prior procedures should become reduced as the product depletes. Simply waiting out the final result may be the most appropriate direction for you as you noted you underwent three separate procedures in a short period of time. The 'pointy' chin can result when placing a focused deposit of filler as opposed to using a bit more product and feathering it along the jawline to widen the frontal appearance. Also the placement of the filler lower on the chin can also give the appearance of a lengthening and 'pointy' change. I hope that helps in your thought process. I would recommend slowing down the process and see if it matches your expectation with time. If you add even more filler in an attempt to 'fix' the situation, you may like it even less.
Mohs surgery which is an excisional process will result in the creation of a surgical defect. Since many reconstructive repairs are based on the movement of local and adjacent tissue, (which doesn't create new tissue) there will be tensions placed on some of the local tissue. In some cases this can result in the movement of local structures that define one's appearance, e.g. such as the position of eyebrows. As reconstructive surgeons, we are aware of these impacts and will base our reconstructive designs on a number of factors and will take this into account. In some cases, skin grafts are utilized to address surgical defects, and these will allow for less overall tissue movement, however, the appearance of grafts need to be considered as well. If the possibility of asymmetry is a specific concern of yours, you should communicate this to your physician.
The site of your excision is a challenging one as it experiences a great deal of movement and pull. Scars can often widen and/or thicken when on this section of the back. Time tends to improve the overall appearance of most scars, and it was unclear on how recent you underwent the surgery. When the scar has had time to mature, one can consider a number of approaches to improve the appearance including pulse dye laser, or radiofrequency microneedling. In the meantime, if you or some one else could place either a silicone pad or silicone based gel on the site daily, that would help the condition of the scar. I would encourage you to be patient and see how it may improve with time. If ultimately, after making attempts to improve the scar, one could consider a re-excision of the scar. This type of work is typically performed by a dermatologic surgeon or plastic surgeon with experience in scar revision. Always remember, undergoing another surgery doesn't change the location of the wound which was a major contributor to the acute appearance. Good luck.
