MtF Hair Transplant Surgery, 3 Things you must know

MtF hair transplant surgery plays an important role in facial gender affirmation. We know the upper portion of the face is often a source of dysphoria for trans women. After all, when we interact with other people, most of our time is spent looking at what surrounds their eyes.

However, the brow bone bossing is not the only characteristic which can result in misgendering by strangers. The height, shape and density of the hair also influence gender recognition, particularly when the bottom two thirds of the face are covered by a mask.

How does Mtf hair transplant surgery help?

Transfemme or feminine leaning nonbinary individuals who opt for FFS surgery often request feminizing hair transplants. However, both femininity and natural results are key. For a hair transplant to look natural, the approach and design are very important.

Women’s hairlines are stereotypically more rounded, that’s to say, without peaks or large entries in the corners. In addition, a naturally harmonious hairline is in balance with the rest of the face.

Recreating the ideal female hairline requires a methodic analysis based in part on the following points:

  • Extent of widow’s peaks and quality of potential donor sites
  • Diagnosis if alopecia, or hair loss, is active
  • Feasibility of MtF hair transplant options. Not all patients are candidates for this approach.
  • Realistic and personalized design of the new hair line.

The team will discuss the alternatives that are most appropriate for your gender-affirming hair transplant surgery. Key aspects to consider when having MtF hair transplants relate to the design, quality and positioning of the grafts.

Feminize the Hairline Height

Hairline height, or the distance between the hairline and the brow is incorrectly considered a gender trait. Some may still disagree, but the height of the forehead is NOT an indicator of gender. Due to this erroneous perception, it used to be common practice to perform a hairline advancement procedure to bring it down.

However, research by Alexandra Hamer of Virtual FFS shows that female hairlines are ironically slightly higher, on average, than male hairlines that haven’t receded due to balding. The misconception of a high hairline being masculine is due to widow peaks causing the forehead to seem larger or taller, when really the problem is the square or M-shape.

Now, the top experts in the field of MtF hair transplant surgery agree that patients won’t benefit from an excessive hairline lowering since this can actually be masculinizing. A low hairline that creates a small, short forehead is undesirable, especially on rather long faces.

Finally, this “scalp advancement” can adjust the position but not the shape of the hairline. The main pitfall is that it requires an incision that results in a visible scar along the hairline which will likely need hair transplants to cover.

Feminize the hairline shape

The characteristic shape of a typical masculine hairline may be the reason behind the misconception that female hairlines are lower. For this reason, people are surprised how modifying the hairline shape is much more beneficial than adjusting the height of the hairline.

Note: Hair transplant surgery isn’t meant to be perfectly symmetrical, but irregular. In addition, the direction or orientation of each hair follicle will also be essential, matching the native hairs so the final result is homogeneous.

The most effective way to create a more feminine hairline in most FFS patients is to redefine it’s shape using simultaneous hair transplants or SHT.

Facialteam has pioneered one of the most advanced hairline feminization procedures. It combines simultaneous MtF hair transplant surgery with forehead reduction surgery.

A study published on this technique is now frequently referenced in many other scientific articles on hairline feminization. This innovation means that the entire upper portion of the face can potentially be feminized in a single procedure and without visible scarring.

In this way, the recessions near the temples can be filled in, rounding out the overall shape and creating a more feminine appearance. In some cases when there are sufficient follicles available, they may be grafted into other areas for the best result.

Improved Hair Density with MtF Hairline Surgery

For patients with thinning hair at the hairline due to hormonal causes, increasing the density is possible with MtF hair transplant surgery. The density can often be improved at the same time the shape is being redefined, depending on each patient’s individual case.

Determining the number of Follicular Units (FU’s) is very important in MtF hair transplant surgery since the correct density in the target areas is crucial. Some areas will need more density and others less, just a natural hairlines vary.

Therefore, the number of estimated grafts conditions the preplanned design. If there is low density in the donor area, meaning there are fewer follicles for extraction, then the area to be filled is limited by this.

Pitfalls of MtF Hair Transplants

Ineffective outcomes, such as unnatural-looking plug rows in straight lines, can be avoided by having multiple consultations and getting third opinions. Be sure to choose the clinic that has the consisten results you seek.

Sometimes, when hair loss has been extensive or if the peaks of the M-shape are particularly high, more than one hair transplant procedure may be required for optimum results. Also, it is not always possible to predict the quality and quantity of hair grafts without a prior analysis in person, so the number of grafts may vary. An experienced professional will be honest about this.

As with any surgery, there are associated risks such as infection that every patient must well-informed of in advance of surgery.

MtF Hairline Surgery Cost

The price of Hairline Feminization can vary, as the combination of diagnostics, techniques and procedures are personalized to your particular situation. In general, an MtF hair transplant costs anywhere from 7.800 to 8.400 Euro with Facialteam (including hospital fees and anesthesia). Depending on the details of complexity and if you choose optional aspects, the final cost may be higher or lower.

The following services are included in all our quotes;

  • Pre-operative consultation, standard pre-operative preparations and necessary revisions
  • Preoperative and postoperative CT-scan
  • Material costs
  • Costs for the operating theater and general anesthesia
  • 1 night in hospital
  • Postoperative accommodation (average of 12 nights, variable according to procedure and surgery dates in case your surgery is in Marbella. For Barcelona patients we can suggest a nearby Hotel)
  • Lymphatic drainage massage
  • Acupuncture service
  • 24 hour coordination support and round-trip transport for appointments
  • Post-operative nursing care
  • Health insurance for surgical complications up to 30 days after your surgery

Hair transplants for facial feminization

MtF Hair Transplant Surgery can help to create a more rounded hairline shape or to counteract density problems due to balding patterns–solutions which may give the impression of a smaller, female forehead. On the contrary, the hairline incision for a scalp advancement is no longer considered an effective way to resolve the perception of a masculine-looking high forehead due to the potential for visible scars.

Hair transplant surgery which is adapted to the objectives of male-to-female patients, however, is a safe and predictable way to maximize forehead feminization for the ideal female hairline. Deliberate irregularity, asymmetry and artistry in the placement of transplants at the hands of a skilled surgeon contributes to a natural looking hairline.

Changing gender perception with natural results is as much an art as it is a science. A person’s unique facial features should be taken into account to ensure the final result is harmonious and balanced.

We suggest consulting with several surgeons, whose approaches will vary, in order to make a more informed decision of what is best for you.

Speak with a surgeon

Do you want to speak with an experienced FFS surgeon about MtF Hair Transplant Surgery?
Having a feminine hairline shape makes a big difference.
We offer free evaluations to help you find the right procedures.

Patient Relations Manager Lilia Koss, presentator of Lilia's Livestreams
About the author

Hello world! I’m Lilia Koss and I use she, her, and they pronouns. What are yours? With a background in humanities and diverse professional experiences, I have been working with the Facialteam founders and directors since 2008. Involved from the ground up, so I’ve had hands in many pots: patient coordination, orientation events on 3 continents, social media, written and audiovisual content about our gender-affirming healthcare...but now life is more defined. Lately, I focus my energies on Public Relations, community management and live streaming to help raise the visibility of trans health. Life is pretty complete.