Gaunt, hollow and lumpy after facelift revision - what happened & is further revision needed? (Photos)

I had a facelift 5 years ago and a revision soon after to correct the excess skin. I was happy with the result until recently when it had dropped significantly and I felt it required further revision. I consulted with a number of surgeons who agreed. The surgeon I chose recommended a deep plane facelift, scar revision and correction of the malar fat to remove the bumps by my mouth. The first photo is 3 weeks after the procedure. The second, 3 months. What has happened? Further revision?