Transgender females and males now have a wide range of resources to help complete the process of aligning their physical appearance with their gender identity. Hair transplantation to create the correct feminine hairline for transgender women and facial hair transplants to further masculinize the appearance of transgender men have gone mainstream, and are heavily promoted – making the caution to choose your surgeon wisely more relevant than ever.

Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – has been honored to help our transgender patients fulfill their challenging journey. As one of the first hair restoration surgeons in the United States to welcome transgender patients with respect and support, Dr. Barusco continues to serve members of this diverse community through his experience, skill and strong sense of aesthetics.

“We have many patients who come to us for help during their transition period,” says Dr. Barusco. “Of course, that involves a lot of medical therapy, hormone replacement and commitment on the patient’s part. I greatly admire the courage of people who are going through these transitions, as they are not easy from a psychological or social standpoint.”

If you’re ready to take this next step in your transition, you may already be knowledgeable about your hair transplantation options. However, there is always something new to learn. Because you want to achieve the best possible result, we will look at the many factors involved, and the elements that can affect the process.

We also invite you to watch Dr. Barusco’s video – “Hair Restoration Surgery for Transgenders” – on his YouTube channel, Hair Loss Medical Advice. In this informative video, Dr. Barusco discusses the process in greater detail, and describes the procedure he performed for Ronie, a transgender woman who wanted a feminine hairline and correction of balding scalp areas so she could feel complete as a female and confident going out in public without a wig.

The Art and Technique of Creating a Feminine Hairline for Transgender Females

For those transitioning from male to female, the male hairline presents an aesthetic obstacle, as the hairline and growth patterns for males and females are noticeably different. As our blog post – “Transgender Hair Transplants – Becoming Your True Self, Beautifully” – notes, the male hairline has the following characteristics:

  • A lower overall position.
  • M-shape – temporal corners are further back.
  • Forward flow pattern frontal hairs – angles project straight forward.

Conversely, the female hairline is characterized by the following:

  • A higher overall position.
  • Inverted U-shape – creates an oval effect.
  • Frontal hairs in a backward-facing whorl flow pattern – also known as a “cowlick” growth pattern.

For this reason, we introduce our first note of caution. If the hair restoration surgeon you consult recommends a hairline lowering procedure, know that this technique won’t produce a good result, as it was designed to address issues with a cis female hairline. The objective here is to create a female hairline, rather than to correct one. Lowering the hairline alone does nothing to fill in the outer temple areas, which are critical to crafting the new feminine hairline.

Here is where the skill and artistry of the hair transplant surgeon is of particular importance. There is more to creating a feminine hairline than simply making an oval shape around the face. Just as a cosmetic surgeon specializing in rhinoplasty carefully considers the unique facial characteristics of each patient to reshape the nose in perfect, attractive proportion to the face itself, so does an advanced hair restoration surgeon in performing hairline feminization. There is no one-shape-fits-all approach. The surgeon must be able to correctly place each hair graft so that the hair grows and falls around the face in a natural, pleasing manner. The ideal outcome is the achievement of feminine beauty, not just an appropriate hairline.

Addressing Male Pattern Baldness in Transgender Females and Males

Depending upon when you began your journey transitioning to female, you may have been experiencing hair loss as the result of androgenetic alopecia. This is popularly known as male pattern hair loss (although it also occurs in women), and is genetically predetermined. Undergoing hormone therapy will help to slow or stop further loss as estrogen levels increase, but it can’t reverse existing hair loss. Only a hair transplant procedure can address bald areas of the scalp.

In the case of balding at the crown (vortex), a transplant can be successful and achieve the look of natural growth. Our blog post – “Crowning Glory – The Art of Hair Transplantation to the Crown Area” – covers the challenges involved, as well as the cross-hatching technique developed by Dr. Barusco, which he has written about for medical textbooks and reference publications.

Those transitioning from female to male may begin experiencing androgenetic alopecia as testosterone therapy replaces estrogen. For either situation, the same types of hair transplantation procedures apply:

Follicular Unit Excision (FUE) – In this procedure developed by Dr. Barusco, follicular units in groupings of one, two or three hairs are individually extracted from the back of the head using small circular punch blades instead of a scalpel. The grafts are then transplanted to the thinning or balding areas of the scalp. Once the desired number of grafts are obtained, the donor sites are left to heal without suturing. The resulting scars are not readily visible and are easily concealed even by very short hair.

No-Shave FUE – Also developed by Dr. Barusco, the no-shave FUE completely conceals harvested donor sites immediately, allowing you to resume your regular activities with virtually no evidence of the procedure.

Follicular Unit Transplantation (FUT) – Also known as the “strip” method, the FUT procedure has undergone refinements over the years so that the only evidence is a pencil-line linear scar easily concealed by hair – even at a shorter length.

Combination FUE and FUT – This technique covers large areas of baldness in a single surgery. Patients with advanced hair loss are typically required to undergo multiple hair transplant procedures to obtain coverage – having to wait one year or more between procedures. This allows patients to achieve their ultimate goal sooner, with one procedure versus many. The combination FUE and FUT could be an appropriate procedure for those who began their male-to-female transition later in life, when hair loss from androgenetic alopecia was already well under way.

Facial Hair Transplants for Transgender Males

Facial hair transplant surgery is popular among transgender men to further masculinize their appearance so they can confidently be at ease in the world. Hormone therapy promotes facial hair growth, yet is often not dense enough to grow a full beard, mustache or sideburns. An eyebrow transplant may also be needed to provide the fullness typical of male eyebrows.

Techniques used for facial hair transplants differ from those used for the scalp, because the length, texture, characteristics and growth patterns of the hair differ. An experienced surgeon such as Dr. Barusco knows how hairs from different areas of the body behave, and has the skill and artistry to harvest those that are the best match, thereby ensuring the hair follicles are angled correctly when transplanted. Be aware that not all hair restoration surgeons are equal in their ability to create the appearance of natural facial hair growth.

Choose Your Surgeon Wisely, and Live Your Best Life as Your True Self!

You already have valuable experience in choosing the team of physicians and surgeons who have brought you this far. Knowing who to trust to make your new life a reality is important, and making the right hair restoration surgeon part of your team to provide the finishing touches is vital.

Ultimately, choose your surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device. 

Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you live your authentic best life!

Author: Tempus Hair Restoration