We know today that facial aging is a 3-dimensional process: wrinkles and sun damage to the skin, loss of volume, and general drooping of tissue. Instead of pulling it all up and snipping it off in a traditional facelift procedure (can you say "wind-blown" look?), surgeons today are filling lines with soft tissue fillers (Restylane, Perlane, Juvederm) or fat, and picking up that excess skin by revolumizing the midface (cheeks). Often referred to as a liquid facelift, if the needle can effectively meet your goals, a surgical facelift not necessarily indicated.
But that isn't to say that the facelift is a thing of the past. If you haven't taken preventive measures along the way, have significant drooping skin, and the aging process has simply caught up with you, a surgical facelift may be needed to meet your rejuvenation goals.
At the end of the day, it's all about a customized approach to your face. If there's one thing we know for certain in the aesthetic industry (contrary to past approaches), one size does not fit all!