The journey to becoming one’s true self is filled with challenges when that journey involves transitioning from the gender assigned at birth to one’s authentic identity – be it from male to female, or female to male. Transgender hair restoration surgery is typically the last step to achieving the natural appearance that aligns with the patient’s gender identity. Understanding the differences between male and female hairlines is of critical importance in hair transplants for both transgender females and males – as well as possessing the experience, skill and sense of aesthetics to successfully work with concealing scarring from previous procedures, such as surgical facial feminization.

As we celebrate Pride Month, Tempus Hair Restoration has been honored to help our transgender patients complete their journey, happy that the person they see in the mirror finally, truly reflects who they have always been inside.

As with all other surgical procedures in the transitioning process, choosing the right surgeon is critically important to attaining the desired result. Dr. Marco Barusco – Founder and Chief Medical Officer of Tempus Hair Restoration – has more than 20 years of experience in performing and innovating advanced procedures, such as the No-Shave FUE. His artistic eye and unsurpassed technical skill allow him to create the best effect for each patient.

The differences between male and female hairlines

The hairline and growth patterns for males and females are noticeably different.

The male hairline has the following characteristics:

  • A lower overall position
  • M-shape
  • Forward flow pattern frontal hairs
  • Male pattern baldness

The female hairline is characterized by:

  • A higher overall position
  • Inverted U-shape
  • Frontal hairs in a backward-facing whorl flow pattern
  • Overall thinning

In a male-to-female transition, surgical feminization of facial features consists of such procedures as brow bone reduction, tracheal shave (Adam’s apple reduction), jaw contouring and rhinoplasty. Feminizing the hairline completes the desired aesthetic effect.

This is where the skill of an experienced hair restoration surgeon is essential. Unlike female hairline lowering for biological (also known as “cis”) females – which brings down the hairline to correct the effects of hair loss at the front of the scalp – the procedure must convert the M-shaped male hairline into the feminine U-configuration. Cutting a long incision to advance the hairline cannot fill in the outer temple areas. In addition, hairs in the male hairline grow in the opposite direction and flow to those of a female.

Complicating factors may include permanent forehead scarring as a result of brow bone reduction surgery. Much like the scarring caused by a facelift, healing can be successful, yet leave undesired evidence of the procedure. Scars can be concealed through utilizing advanced hair transplant techniques, which requires a surgeon with a proven record of performing challenging procedures.

Finally, the creation of an attractive hairline is not a one-technique-fits-all process. A surgeon with basic technical skill can construct a female hairline. However, to create a flattering hairline that complements the client’s facial features requires an artistic eye and the ability to correctly place each graft so that the hair grows and falls around the face in a natural, pleasing pattern. As we always emphasize, not all doctors who perform hair restoration procedures have the ability to provide the highest level of natural-appearing aesthetic results.

With transgender hair transplants, another factor in the equation can be male pattern hair loss. Male-to-female transgender clients who begin transitioning at a young age are less likely to experience this type of hair loss, due to the early intervention of hormone therapy. However, if balding has begun at the time of transition, hair restoration treatment will be necessary. Estrogen therapy may prevent further loss, but cannot restore hair that has already been lost.

In the case of female-to-male transgender clients, those who have a genetic predisposition to male pattern baldness may start to experience hair loss. Again, an evaluation of the client’s individual situation will determine the best course of treatment – be it adipose tissue and growth factor therapy, a hair transplant procedure, or a combination of treatments.

As with transgender women, cosmetic surgery is available to create masculine features for transgender men. Facial hair transplant surgery is a popular option to achieve the client’s ultimate goal of being at ease in the world as a self-confident man – as well as to create this appearance without intensive cosmetic surgery. While hormone therapy may promote facial hair growth, it often is 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 – understands how hairs from different areas of the body behave, and has the skill and artistry to harvest those that are the best match, and ensure the hair follicles are angled correctly when transplanted.

Although June is designated as Pride Month, the long journey for transgender women and men deserves recognition and respect no matter what the calendar date. We provide a supportive environment for our transgender clients, and are here to help you achieve your desired outcome.

Our client, Ronie, took her time to provide a video testimonial about her hair replacement experience at Tempus Hair Restoration. Ronie wore wigs and hats for years to cover her hair loss. After learning about hair restoration surgery, she wrote an emotional letter to doctors all over the country asking for their help. Dr. Barusco was the only surgeon to respond. We thank Ronie for sharing her story and having the courage to prevail. Contact us to schedule your free virtual consultation with Dr. Barusco to learn your options, so that you can live your best, true life!



Author: Tempus Hair Restoration