If you are trying to achieve a more feminine facial appearance, you may know that hair, and specifically, the shape and height of your hairline is a major component of this transformation.
Your hairline frames and defines your face, making hairline lowering a particularly important component of facial feminization surgery for both transgender and cisgender women seeking a more feminine appearance.
For example, a masculine-shaped, higher hairline will make a small nose or long eyelashes appear more masculine; whereas a softer, lower, more feminine hairline can feminize a face, even if you have a strong jawline and thick brows.
There is a wealth of information—and misinformation—on the Internet about the female hairline, including shapes and heights. With this in mind, we want to demystify some common misconceptions and debunk popular myths to ensure that you have all of the information you need when considering any form of hairline surgery.
Really, the opposite is true. Draw an imaginary line between your brows, just above where the nosepiece of your sunglasses would rest. This anatomic landmark is known as the glabella. A male hairline will typically begin 6-8 cm above this, whereas a woman’s hairline will start at about 5.5 cm above the glabella.
If your forehead appears longer or more masculine than you would like, you may want to consider lowering your hairline. Hairline lowering is accomplished either with hair transplantation surgery or with surgical hairline advancement (sometimes with both) to make the hairline appear more feminine.
Both procedures can be extremely effective when performed individually or in combination with each other.
Beyond the actual placement of the lowered hairline, the location and shape of the hairline are equally critical. Due to this, the peaks and valleys of the hairline also get a lot of attention when performed as part of Facial Feminization Surgery (FFS). In fact, to achieve a desired natural shape, many patients will work with their doctor to determine exactly where they want to locate each swoop and peak.
It is also important to pay close attention to the natural muscle movements of your face. For example, if you raise your eyebrows and deliberately make wrinkles on your forehead, you are using your frontalis muscle.
Except at the very center, adult male hairlines will naturally start about 1cm above the frontalis. Adult women’s hairlines start exactly where this muscle ends on your forehead. While it might seem like transplanting hair right up to the edge of the frontalis muscle would feminize any hairline, it is not that simple, nor that easy, because the typical male frontalis muscle is naturally higher than a female’s.
To make the hairline low enough to resemble a woman’s, you would have to transplant hair directly onto the frontalis muscle. In the past this approach was attempted, and although the hair grew, the results were less than desirable. Since hair almost never grows on top of the frontalis muscle naturally, if it is placed there artificially, it moves up and down with each facial expression—an unnatural and unsettling result.
Because the frontalis muscle and underlying bones are larger in males than females, there are many factors to consider when feminizing the hairline. Any efforts to make a male face seem more female has to involve more than just hair transplantation—the hairline needs to be lowered, and the underlying bones and musculature must be appropriately restructured.
Most men start to lose hair from the frontotemporal corners of the hairline, often as early as high school. For the fortunate, the recession ceases, resulting in a “mature hairline” that can make a man appear “distinguished.”
While perhaps less obvious, women can also experience thinning hair at the frontotemporal corners. The primary difference is that females never lose all of that hair; they just experience thinning which results in wispy, fine hair in the corners, mimicking the male hair loss pattern. Conversely, males have the tendency toward slick baldness in these areas, known as the “receding hairline.”
So what do you do if you want a more feminine hairline but you already have a masculine hairline with male pattern hair loss?
The solution is easier than you think.
Individual hair grafts applied in the frontotemporal corners will simulate the fine texture that female hairlines typically have in those corners. It is important, however, to be sure single-haired grafts are used to ensure that the hair at the frontotemporal corners appear wispy and feminine. Often, a short 1centimeter “transition zone” of individual hair grafts is all that is needed to create a subtle feminine appearance.
It is also important to note that not all hair transplant surgeons may be able to accomplish such precise single-hair grafts that achieve a more feminine appearance and resolve male pattern loss at the same time.
An experienced surgeon also knows that the shape of a feminine hairline is rarely straight across. The feminine hairline appears relatively “swoopy,” due to lateral mounds, widow’s peaks, and concavities/convexities; we will use our knowledge of these intricacies to ensure the best look possible for you. Women’s hairlines will often “sweep” to one side or another (most often to the right) as the direction of the hair changes. Conversely, men’s hair typically grows in a forward direction, so adding a little curve can help add that feminine touch.
In addition, more than 80% of women have a widow’s peak—that small V of hair at the hairline that points down toward the nose. So in order to further feminize the hairline, a soft widow’s peak is often added at the center of the hairline.
In short, when it comes to feminine hairlines, dense hair across the forehead is both a factual misrepresentation and an undesirable goal. A feminine hairline will have subtly “rounded” corners with delicate, wispy hairs that create a more softened, female appearance.
As we have seen, when trying to achieve a more feminine appearance, hair is one of the most important features. However, achieving a full head of feminine-looking hair can be a challenge if you were not born with it. Many people with male pattern hair loss fear that a wig is their only option. Depending on the individual patient, however, other solutions may be available.
With natural female pattern hair loss, known as androgenetic alopecia, hair thins naturally all over the head, not just at the hairline as with men. Due to the fact that the hairline is typically preserved, just creating the hairline lower on the brow will naturally give a masculine face a more feminine appearance along the hairline and frontal area.
The next step depends on how much donor hair the patient has, and whether Facial Feminization Surgery is to be performed as well. When hair transplant surgery is performed in conjunction with Facial Feminization Surgery, two very desirable results can be achieved—naturally softening the hairline and concealing any possible scars resulting from other FFS procedures.
FFS surgery may actually enable a patient to have more hair than a typical hair transplant surgery might allow, by salvaging the hair that might be lost as the scalp is repositioned. If, however, no further hair is available to transplant, a partial wig placed behind the hair (either naturally growing or grafted) may be the best solution.
Placing a partial hairpiece in this location enables the hair to look fuller even if the patient’s own natively growing hair is not abundant. And, it appears more natural at the edges where is it most visible.
Partial hairpieces or wigs, are created to perfectly match a patient’s existing hair, providing seamless aesthetic result. And, they can be instantly removable or attached semi-permanently for months at a time, depending on the individual patient’s needs.
Regardless of the state of a patient’s hair reserves (aka “donor hair”), feminization surgery plans should incorporate the use of all available hair grafts to optimum advantage. Contrary to popular belief, women are not necessarily born with more hair, but since they tend to retain more hair as they age, most male-to-female transitions will need assistance in this area. So, keep in mind that while individual results vary, there are many options for hairline lowering, grafting, and facial feminization.
If you have any questions about hairline lowering, hair transplantation, or FFS, be sure to review all of the available options, and choose your team wisely so that you will end up the with the best possible results.
Want to know more about hairline advancement surgery? Please contact our San Francisco office +1.415.624.3922.