Why Choose Dr. Zenn?

  • Dr. Zenn focuses primarily on facial rejuvenation procedures in his practice
  • Dr. Zenn completed additional fellowship training in Head & Neck and Facial Surgery after his prestigious Harvard Plastic Surgery residency
  • He served as Co-Director of Duke University’s Facial Reanimation Program, a one of a kind regional program that treats complex congential and trauma cases by recreating smiles
  • Served as editorial board member for the medical publication “Head and Neck Surgery
  • Dr. Zenn is rated as a Castle Connolly Top Doctor for Cosmetic Surgery
  • Dr. Zenn is Board Certified by the American Board of Plastic Surgery

What is a Necklift?

As we age, many people notice excess fat and/or sagging skin in the neck area. This results in the loss of that crisp 90-degree angle that defines a youthful profile. A sagging neck can occur for a variety of reasons. Some people are overweight and fat collects in the chin area. Others experience massive weight loss that leaves excess hanging neck skin. And some age earlier than others based on inherited anatomy. For example, people with a small chin or a short neck tend to see more severe neck skin sag. Regardless of the cause, excess fat and skin in the neck area is a very common complaint among patients. Luckily, a necklift can address these conditions and make you appear younger.

Your Consultation

Dr. Zenn’s extensive experience with facial surgery provides him with many strategies and techniques for necklift surgery. There is no cookie-cutter solution to this problem. Every patient’s anatomy is different and requires individual evaluation and treatment. And every plastic surgeon will differ in their approach and skill in correcting these issues.

During your initial consultation, we encourage you to openly share your aesthetic concerns with Dr. Zenn. This is an opportunity to talk about what you like and dislike about your neck area. It also gives you a chance to get to know Dr. Zenn. Once he has learned about your health background and has a clear understanding of your goals and expectations, he will examine you to determine if a necklift alone or in combination with other procedures is the best plan to address your concerns.

Following your exam Dr. Zenn will share his extensive gallery of before and after photos with you. He will show you past patients who had similar concerns to yours — and explain what he did to correct their problem. Your personal treatment plan will be developed based on aesthetic evaluation, your desires, and the amount of downtime you have available for recovery. When you are ready to move forward, you will schedule your pre-operative appointment and surgery.

During recovery, I was able to call Dr. Zenn directly and text photos. This was convenient as I flew from Ohio to have this surgery.

Dr. Zenn’s Approach to Necklifts

Dr. Zenn may recommend one of a variety of treatments for problem areas of the neck:

Liposuction of the Neck

Liposuction of the neck area works best if the loss of neck definition is due to excess fat and the skin remains elastic. This is typically seen in younger patients, aged 25 to 35. Since the procedure is performed with small stab incisions, recovery involves some swelling and bruising but little scarring. Dr. Zenn recommends limiting activities for the first week following this procedure.

Isolated Neck Surgery

This surgery allows Dr. Zenn to tighten specific neck muscles and directly remove fat from the neck. No skin needs to be removed because the redefined depth of the neck allows the skin to re-drape smoothly. Once the skin settles in its new location it establishes a more defined and youthful appearance. This surgery is performed with a single hidden incision under the chin.

Chin Implants

One anatomic feature common with poor neck definition is a weak chin. The greater the chin’s projection the more support there is for the skin and a more defined neck. The opposite is also true. The smaller and less projected the chin, the less support for skin which then tends to gather in the neck area. Placing a chin implant in patients with weak chin projection will help support any excess skin and thus better define the neck. An added benefit of a chin implant is that it balances facial proportions which is also aesthetically pleasing.

Dr. Zenn will place a chin implant through a hidden incision in the mouth to give increased projection to the chin. Pain from the procedure is minimal and patients can expect some tightness and swelling the first week. The implant is permanent.

The example below demonstrates….


Non-Surgical Necklift

There are non-surgical products that can target the aesthetic concerns isolated to the neck.


If you are exploring a necklift because you want to get rid of a double chin or jowls, you may benefit from Kybella®, an injectable solution that helps to eliminate neck fat under the chin and jawline without surgery. The deoxycholic acid in Kybella destroys fat cells permanently.

Injections are performed in the office and without the need for anesthesia. After injection, patients experience a mild burning sensation for up to 30 minutes that is tolerated well with an ice pack. Swelling is noted for the first few days and a minority of patients have associated bruising.

For best results, multiple treatments of Kybella are recommended over a period of months. Dr. Zenn can examine you and give you an estimate as to the recommended number of treatments for your particular anatomy.

Botox (or other neurotoxins)

Sometimes a sagging neck is not caused by excess fat but a problem with active neck muscles.

In fact, when neck muscles contract there appears to be extra skin in the neck, but there isn’t! For these patients Botox® may take care of the problem. It is counterintuitive, but Neurotoxins, like Botox paralyze the superficial neck muscles, which have no real function. With the muscles relaxed, the skin sits more smoothly in the natural contours of the neck, giving a youthful appearance.

Not all providers of Botox offer this injection. Dr. Zenn is an expert in anatomy of the neck and has been safely treating neck bands with Botox for more than a decade. Botox takes effect in three to five days and generally lasts three to six months.

How Necklift and Facelift Are Related

Raleigh patients seeking necklift often have other prominent signs of aging in their mid-and lower face.

These changes can include:

  • Drooping and deflated, flattened cheeks
  • A poorly defined jawline with obvious “jowls”
  • Descent of the eyebrows and nasal tip and elongation of the earlobes
  • A separation between the lower eyelid and cheek with lower eyelid “bags”

Patients spend extensive time in consultation with Dr. Zenn. He wants each patient to understand the cause of their neck concerns and how enhancements in other aspects of their face can improve the final overall result. A necklift is automatically part of a facelift; a facelift involves more extensive changes in the mid-lower face. Dr. Zenn’s approach to facelift surgery can be found on the facelift procedure page.

As part of any treatment at Zenn Plastic Surgery, you will benefit from expert care throughout your experience. Dr. Zenn and our staff are committed to your comfort and your safety, and we will be available to answer any questions you have before your surgery and during your recovery.