Your forehead and hairline make a significant contribution to the gender appearance of your face, so it’s natural that you might want to make changes as soon as possible.
Hair transplants might sound like an easy “quick fix” for your hairline but if performed first, they can significantly impact future options for facial feminization surgery (FFS).
The masculine forehead is naturally longer, with the hairline sitting further back on the skull than on a person with a feminine hairline. A receding hairline can make the forehead appear even more masculine.
Different surgeons use different surgical approaches to feminizing foreheads and hairlines so before you commit to hair transplants, we recommend you carefully consider your options. Discussing your final goals during a consultation can help you to plan for the best result for your feminine transformation.
For many, hairline lowering surgery in combination with careful use of hair transplants can be effective elements of facial feminization and can give you an even more natural effect that will help you reflect your femininity to the outside world.
Female hairlines are approximately 2 inches (5.5 cm) above the brows whereas, in males, the hairline is approximately 2.75 inches (7 cm) above the brow.
Adjusting the height of your forehead and the shape of your hairline is an important element of FFS. For many cases, we recommend two staged procedures:
- First, we perform hairline lowering (scalp advancement) – to lower the hairline or shorten the height of the forehead
- Then, if necessary, hair transplants – to fill in the temples or conceal a scar some months after hairline lowering.
We strongly recommend hairline lowering prior to any transplants to both lower the forehead and provide naturally thicker hair in the central area of the hairline. Hair transplants used to lower the central area of the hairline are not our preferred option because hair transplants do not provide sufficiently dense hair for the central area and may not actually give you the natural feminine hairline you desire.
Hair transplants are typically not usually dense enough for the central area of the hairline but are an excellent option for filling in the temples or a receding hairline and also for camouflaging an incision from previous hairline lowering. Cisgender women have thinner hair at the temples and so the thinner nature of hair transplants is ideal to help create a natural, more feminine look.
Hair transplants can also be used to conceal a scar from hair lowering surgery but for this to occur, you need to consider the timing of hair transplants relative to your other procedures. Months after hairline surgery, the presence or not of a scar will become obvious and dictate whether a hair transplant is needed.
As with all FFS procedures, the timing of hair transplants will have a large impact on your final results.
The wait is over! Dr. Deschamps-Braly’s new book “Facial Feminization Surgery: The Journey to Gender Affirmation” is back and available now. This second edition covers the advances in facial feminization as well as helpful patient stories and is a great resource for FFS patients and their loved ones.LEARN MORE
We recommend our clients have hairline lowering and FFS first because of the significant advantages of not rushing into hair transplantation:
- Hair transplants can be used to perfect your feminine hairline and your final look after other FFS procedures have been completed.
- Hairline lowering leaves your temples untouched making that area more receptive to future transplants.
- More than one hairline lowering procedure can be performed, if required, to adjust the height of your forehead.
- Hair transplants can be used to camouflage any scars arising from earlier hairline lowering surgery.
- Hair transplants have a better survival rate when performed months after hairline lowering.
- The risk of scalp tissue death (necrosis) is greatly decreased if the hair transplant is performed more than six months after hairline lowering.
We recommend most of our clients delay hair transplants until after hairline lowering surgery and brow-lifts.
Disadvantages of hair transplantation performed before FFS include:
- An inability to have future hairline lowering surgery
- Areas previously transplanted can become less likely to accept future transplants to perfect the hairline
- Loss of the transplanted hair and other scalp hair from “shock hair loss” can take months to regrow and delay FFS
- Loss of previously transplanted hair during future forehead or brow feminization procedures
- Wasting of precious scalp hair that could be used for future hair transplants.
Some surgeons recommend performing hair transplants and hairline lowering simultaneously. One potential advantage of this technique is that skin and hair removed during hairline lowering can be immediately used as a transplant.
However, as described above, we recommend staging the procedures. Delaying hair transplantation has advantages including a better transplant survival rate and hiding any scars that form after hairline lowering.
Importantly, we have found that delaying hair transplants is a better option to perfect your hairline and give you a more natural feminine result.
Please note that we do not perform hair transplants at The Deschamps-Braly Clinic. However, we insource the skills of Sara Wasserbauer, M.D., F.I.S.H.R.S, a Diplomate of the American Board of Hair Restoration Surgery, and a Fellow of the International Society Of Hair Restoration Surgery. Find out more about Sara on her website: https://californiahairsurgeon.com/.
- Facial Feminization Surgery – A Complete Guide to FFS
- Feminizing Hairline Lowering (Scalp Advancement)
- Shock Hair Loss After Scalp Surgery
- Debunking Three Common Myths About Female Hairlines
- Approach to Feminization Surgery and Facial Masculinization Surgery: Aesthetic Goals and Principles of Management. Deschamps-Braly JC. Journal of Craniofacial Surgery, 2019; Apr 2 [Epub ahead of print].
- Commentary on: Nonsurgical Management of Facial Masculinization and Feminization. Deschamps-Braly JC. Aesthet Surg J. 2019 Apr 8;39(5):NP138-NP139.