A full head of hair is a distinguishing feature that adorns, protects, and indicates good health and youth. Baldness in women is particularly distressing because of the greater social stigma associated with hair loss when compared to men. Hair line and hair density are important to consider for trans men who are undergoing feminization.
After breast augmentation, gender reassignment surgery, or facial feminization surgery, a receding hairline, bald spot on the crown, or thinning hair at the top of the head can detract significantly from the feminine appearance you have undergone so much to achieve.
At Beverly Hills Transgender Surgery, Dr. Alexander Sinclair takes a comprehensive approach to transgender feminization. He understands that the relationship of the hair and facial components is as important, or more so, than any one feature taken individually.
If thinning hair, bald spots, or a masculine receding hairline are detracting from your transition to femininity, Dr. Sinclair can perform hair grafting to further refine the process.
Hormonal therapy and testosterone blockers such as finasteride and spironolactone can decrease hair loss and lead to better density, but this method will not produce the desired results for everyone. While some of my patients will opt for noninvasive solutions like wigs, weaves, extensions, and hats, there are other more effective options available.
The gold standard for hair restoration is Follicular Unit Micro and Mini Grafting. Four thousand grafts or more can be placed in a single, minimally invasive procedure under local anesthesia. The method works by redistributing your own hair follicles to the trouble spots around the hairline and scalp. Understandably, the patient satisfaction rate for this procedure is very high and the surgery can be repeated if more grafts are needed.
A procedure known as Scalp or Hairline Advancement is a very effective way to feminize the hairline. Dr. Sinclair will often perform a Hairline Advancement during Facial Feminization Surgery. The procedure can lower the hairline by 1.5 to 2.0 centimeters, making the forehead look more youthful and feminine. The incision is placed along the hair line so as to best disguise the scars as you heal.
By the age of 50, approximately 50% of the male population will experience male pattern hair loss, and in 20%, it can start as early as the late teens. Testosterone blockers can arrest the process in male-to-female patients, and hair that was lost can be restored with hair grafting for a more feminine appearance.
Female-to-male trans patients receiving hormone replacement therapy (testosterone) may develop male pattern hair loss, for which testosterone blockers may also be prescribed. Hair grafting can help replace what was lost for a fuller, more attractive head of hair.
Hair transplants have changed a great deal since their introduction to the U.S. in the 1950s, and the results are much more natural looking and attractive.
In the follicular unit micro grafting process:
Each follicular unit micro graft contains no more than one to three and occasionally four hairs. A combination of different sized grafts is generally used in hair restoration. One-hair grafts are implanted in an irregular pattern along the hairline, while two and three-hair grafts are placed further back for greater hair density. Two or three hairs in a tiny bunch is the way hair grows naturally in most people, so hair transplantation using follicular units is virtually undetectable. The result of this procedure is fuller, thicker, natural-looking hair.