Hairline Feminization Surgery

A masculine hairline before undergoing hairline feminization surgery and the result of a more feminine hairline after hairline lowering Surgery.

Hairline Feminization Surgery is an umbrella term to describe redefining and reshaping the hairline for increased femininity.

So we can offer the best treatment for your desired look, we assess your hairline’s shape, height and hair density to define the best approach to obtain a feminine hairline.

This analysis will help you choose the ideal options for your unique case.

We determine the hairline height by measuring the vertical distance from between your eyes up to the center of the hairline. Hair density is calculated by dividing the number of follicular units (FU) per square centimeter on the scalp. (FU/cm2)

Facialteam has been trusted by over 943 hairline feminization surgery patients since the year 2008. We are proud to report extraordinary satisfaction rates, which inspire confidence in what patients describe as “high quality, life-changing results.”

Redefining Your Hairline to Match Your Feminine Identity

Hairline Feminization is optimal for people seeking to feminize their facial features. The hairline is influential in gender expression and can lead to being misgendered or not. There are several factors that influence the appearance of your hairline. Some common factors are:

  • genetic inheritance;
  • hormones;
  • age;
  • hair care routines;
  • daily habits;
  • prescribed medications.

All factors mentioned are addressed when undergoing hairline feminization surgery. When suggesting a solution, we consider these with the goal of achieving your desired look.

Hairline Feminization surgery contributes to an overall feminization of the face. Through this procedure you can achieve natural and lasting results. The course of action prescribed will depend on the aforementioned variables and your unique facial structure.

To better understand the obtainable results of hairline feminization, we explain how the hairline affects your gender expression.

Hairline Types

Our surgeons’ accumulated experiences have identified five distinct hairline types:

  1. Type I. Hairline with normal height and rounded format.
  2. Type II. Hairline with normal height and receding side temples, or M-shaped.
  3. Type III. A naturally high hairline.
  4. Type IV. High hairline due to alopecia (hair loss) with apparent temples.
  5. Type V. Undefined hairline due to advanced alopecia.

Depending on your hairline type, the treatment suggested could be with transplants or a hair replacement system. Read more to understand these methods and their effectiveness for different hairlines.

Differences between masculine and feminine hairlines

Masculine and feminine hairlines differ in their salient features. Masculine hairlines are generally further back on the scalp and have pronounced foreheads. This forms an M shape as the hairline recedes over time. The hair loss resulting in the M shape is recognized as a male forehead.

In comparison, a woman’s hairline seems to be closer to the eyes. However, it’s a common myth that women have shorter foreheads, despite the fact that many women have high foreheads without appearing masculine. In reality, a feminine hairline tends to be more rounded, creating an oval instead of an M.

The oval shape is what society reads as feminine and is the aim of hairline feminization surgery.

Methods of Hairline Feminization

There are three methods for completing a hairline feminization. They are mentioned below in order of most to least recommended:

  1. Hairline feminization with Hair Transplants (FUSS or FUE)
  2. Hairline Feminization with Hair Replacement System (HRS)
  3. Hairline Feminization with Hairline Lowering Surgery (HLS)

All methods of hairline feminization are effective, when indicated correctly, for creating feminized facial features. Here is an overview of the best method for the aforementioned hairline types.

With over 14 years of experience, our methodology, backed by the outcomes of over 943 successful procedures since 2008, has been recognized and acclaimed in renowned scientific journals.

Hair Transplantation (FUSS or FUE)

Hair transplantation focuses on recessed hairline areas that form an M shape. Therefore this procedure is ideal for patients with type II hairlines provided there is sufficient hair density and little or no androgenic alopecia. We employ two distinct techniques to obtain hair follicles, create hairlines and cover balding areas caused by alopecia.

The first technique is called follicular unit strip surgery (FUSS). In this method, we take hair follicles from a strip of scalp. FUSS is easier and quicker than the alternative technique, follicular unit extraction (FUE), which takes longer because we remove hair follicles individually.

If your hairline is type IV or V due to alopecia causing hair loss on the top of the head rather than the temples, hair transplants are a suitable solution. We can bring forward the hairline with sufficient grafts, for a lowering of up to 1 cm.

You can undergo hairline feminization using transplants before, during or after your FFS procedures. Let us explain with three scenarios.

  1. Simultaneous Hair Transplant during forehead feminization (SHT).
  2. Before facial feminization surgery.
  3. Delayed Hair transplant after facial feminization surgery.

We highly recommend the first option because it has many benefits. Simultaneous hair transplant is the best option for candidates who want combined forehead and hairline feminization. It limits the number of operations required for an optimal feminine result.

Simultaneous Hair Transplant (SHT) with Forehead Feminization

Simultaneous Hair Transplant (SHT) is a technique developed by Facialteam through research and experience. There are three stages involved in the process.

First, dermatologist surgeons identify the best donor area of the scalp. We then preserve the strip of scalp that is removed in the modified coronal approach in order to access the forehead region. Next, hair technicians harvest and prepare the hair follicles in different units. Finally, we design a new hairline by grafting the segmented follicles along your new forehead.

All stages are completed in succession and simultaneously in one operation.

For your safety and to reduce risks associated with prolonged general anaesthesia, we wake you up and use light sedation during the hair grafting stage. This ensures the operation is pain free and performed to the highest safety standards.

If you have androgenic alopecia, it should be stabilized before performing SHT. If hair loss is significant, we can adjust incision positions from the crown to a position further back on the scalp. If necessary, we may even create the incision on the back of the scalp.

SHT has its limitations, which include a maximum number of harvestable hair follicles and covering balding temples with full density. If needed, we recommend a second hair transplant a few months after SHT.

Hair Transplants Before FFS

Some candidates prefer hair transplants to feminize their hairline before FFS.

If you want hair transplant surgery before FFS, it is recommended to wait at least a year before further operations. This will allow your body time to heal and guarantee that hairline grafts are settled. It maximizes the use of hair follicles and secures their viability if they are needed again.

This option is less desirable than SHT due to the waiting times.

Delayed Hair transplant after facial feminization surgery

Some patients delay hair grafting to a separate post-operative session. You may opt for a FUSS or FUE technique.

If you choose delayed hair transplants, you should wait a minimum of 6 months after FFS procedures. This delay time is important so that your face is properly healed and all swelling and bruising are gone. Full consolidation of the soft tissues in operated regions of your face during FFS procedures recreates the ideal environment for hair grafts.

This option requires two surgeries and longer waiting times than SHT.

Stages of Hair Transplant Growth

Undergoing a hair transplant can be a life-changing experience. However, the recovery process is a gradual one, and patients should be prepared for a series of stages as their hair grows and their scalp heals.

We will explore the different stages of recovery after hair grafting, from the initial days to the final result months later. Understanding the different phases can help you manage expectations and ensure the best possible outcome for your hair transplant procedure.

Hair Transplant Growth in the first week

After a hair transplant surgery, the first hair wash is a crucial step in the recovery process. Within a few days or weeks, it is completely normal for the ends of the hairs to fall off, leaving behind “pilot stems.” The skin may also redden as the healing process drives blood flow to the tissues.

Patients may feel some discomfort, such as itching or tenderness, which can be managed with medications and topical aftercare. Follow the instructions provided by the hair transplant surgeon strictly to minimize symptoms.

It is important to avoid rubbing or scratching the scalp during this stage, as this can damage the newly transplanted follicles or cause infections that impede the healing process. Use the nutritional and hair care products as recommended by the specialist to create the ideal conditions for the grafts to settle and grow into healthy hair.

Frontal picture taken from Victoria before surgery
Frontal picture taken from Victoria after surgery
Picture taken at a 45 degree angle from Victoria before surgery
Picture taken at a 45 degree angle of Victoria after surgery
Picture taken from the side of Victoria before surgery
Picture taken from the side of Victoria after surgery
Hair Transplant Growth of an MtF patient in the first week after surgery

While the appearance of the skin and the apparent disappearance of the hairs at this stage may be somewhat disconcerting, it is important to remember that this is a normal part of the healing process.

Hair Transplant Growth after 1 Month

As seen in the before and after images of this patient, 1 month after undergoing a hair transplant, it is common for most of the ends of the transplanted hairs to “fall out” during the initial phase.

Do not be alarmed as new hair growth will begin in the following months. The recipient area which appeared pink or red gradually subsides and returns to its normal skin tone.

Frontal picture taken from Elisa before surgery
Frontal picture taken from Elisa after surgery
Picture taken at a 45 degree angle from Elisa before surgery
Picture taken at a 45 degree angle of Elisa after surgery
Picture taken from the side of Elisa before surgery
Picture taken from the side of Elisa after surgery
Hair Transplant Growth of an MtF patient 1 month after surgery

The initial phase of a hair transplant may seem discouraging as it is a gradual process that requires patience and careful maintenance. With proper care you can expect to see a significant improvement in your hair growth and appearance.

Hair Transplant Growth after 3 Months

Three months after a hair transplant, the first signs of new hair growth begin to appear. Although the number of sprouting hairs is still relatively small and they may appear thin, this early growth is a sign of the success of the procedure.

Keep up the diligence in your aftercare habits to encourage more baby hairs to emerge.

Frontal picture taken from Elle before surgery
Frontal picture taken from Elle after surgery
Picture taken at a 45 degree angle from Elle before surgery
Picture taken at a 45 degree angle of Elle after surgery
Picture taken from the side of Elle before surgery
Picture taken from the side of Elle after surgery
Hair Transplant Growth of an MtF patient 3 months after surgery

Over the coming months, the newly transplanted hairs will begin to thicken and more will appear. This gradual evolution will eventually result in a significant improvement in your hair density and appearance, as the case images show.

Hair Transplant Growth after 6 Months

At the six-month mark after a hair transplant, a high percentage of the follicles have already grown. While the result at this stage of the recovery process is quite advanced, although the definitive result yet to come. This is due to the normal regrowth and loss cycles typical of human hair follicles.

The remaining hairs that have not yet emerged will continue to do so. The thickness of the baby hair shafts will improve. Slowly but surely, the transplanted area blends in with the rest of your hair.

Frontal picture taken from Charlotte K before surgery
Frontal picture taken from Charlotte K after surgery
Picture taken at a 45 degree angle from Charlotte K before surgery
Picture taken at a 45 degree angle of Charlotte K after surgery
Picture taken from the side of Charlotte K before surgery
Picture taken from the side of Charlotte K after surgery
Hair Transplant Growth of an MtF patient 6 months after surgery

While the full results of a hair transplant may take a year or more, the patient can feel encouraged by the progress made thus far.

Hair Transplant Growth after 12 Months

After 12 months, the final result of a hair transplant is practically complete. All of the transplanted hairs have appeared and most have reached their final thickness, resulting in a positive difference in your hair density and appearance along the hairline.

At this point, you may judge the success of the procedure and are likely enjoying the restored hair for a more feminine hairline shape. Regardless, don’t forget to continue the care instructions to protect the young grafts as they develop into healthy and long hairs.

Hair Transplant Growth of an MtF patient 12 months after surgery

A successful hair transplant can be a life-changing procedure for patients who have struggled with hair loss. With proper care and patience, the patient can expect to enjoy the benefits of their restored hair for many years to come.

Hair Replacement System (HRS)

The Hair Replacement System by Cesare Ragazzi Laboratories is non-invasive and can fully or partially restore beautiful hair seamlessly on the scalp.

The Hair Replacement System is best for patients with extreme alopecia leading to an undefined hairline (type V).

The HRS replaces lost hair by means of a dermatologically-tested clone membrane or “second scalp” personalized for your unique hair characteristics. The second scalp is made from selected human hair then hand-woven onto a high-quality and comfortable base. It is designed to match your hair’s features such as density, contour and flow.

Integration with medical-grade adhesive allows for maximum comfort and breathability.

The HRS is designed and integrated with your scalp in seven phases.

  1. Scalp mapping: computer mapping of the scalp and alopecic area.
  2. Cast production: cast created using specialist computer imaging, cloning the contours of the skull and scalp.
  3. Cloning and pantone matching: clone membrane created by robotic technology, replicating the exact shape, lines, and skin tone of the patient’s scalp.
  4. Hair selection and matching: meticulous selection of high-grade human hair to replicate colour and texture.
  5. Implanting: the hairs are implanted individually into the membrane, mirroring the original direction of growth.
  6. Non-surgical grafting: the membrane is non-surgically grafted onto the scalp.
  7. Final styling: professionals complete a final styling as the HRS system is fully integrated.

Since the HRS is non-invasive you can return to normal life without restriction after integration with your scalp. The system includes a personal care consultant who will clean and style your beautiful new hair monthly.

Hairline Lowering Surgery (HLS)

Hairline Lowering Surgery (HLS) is a technique of hairline feminization. This procedure is not recommended for most patients. There are some disadvantages to this technique, which include possible visible scarring, unnaturally small foreheads and inability to improve the hairline shape effectively. These limitations unfortunately may require additional interventions or cosmetic treatment in order to obtain optimal results.

So, the use of this technique is rare.

In our years of experience, only 1% of all patients need this surgery. This technique is used for severe cases of alopecia on the temples (hairline type IV) and unnaturally high hairlines (hairline type III).

In HLS we remove a strip of skin from the forehead and advance the scalp 1 to 2 cm. We carefully make an incision approximately 2 mm inside the hairline behind the implantation line. The incision is placed here so that potential scars are less visible.

This procedure has two benefits. First, it reduces the excess height of the forehead. After the procedure, the distance between your hairline and eyes will fall within more feminine parameters. In addition, we may reconstruct the frontonasoorbital complex in the same session, feminizing all the bone structure in the eye orbits, brow and forehead region.

How much does Hairline Feminization Surgery cost?

The price of Hairline Feminization can vary, as the combination of diagnostics, techniques and procedures are personalized to your particular situation. The overall costs for Hairline Feminization Surgery with Facialteam (including hospital fees and anesthesia) may range anywhere from 7 900 € to 8 500 €. 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;
  • lymphatic drainage massage;
  • acupuncture service;
  • 24-hour coordination support;
  • post-operative nursing care;
  • health insurance for surgical complications up to 30 days after your surgery.

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


There are various approaches to hairline feminization. The suggested procedures will depend on your unique hairline characteristics. Our analysis of your case will help you determine the best options for your facial feminization goals.

Consultations will provide the information you need to be well-informed about your facial feminization journey. They are always free.

We care about your journey and want you to know everything about the procedures you will need for your desired look. At our clinic we are equipped with the latest technology in order to provide the most accurate recommendations in your case.

During the consultation we will talk about your goals together to create the optimal plan for you.

Book your Consultation

We offer both online as in-person consultations in our clinic in Marbella, Spain. Our consultations are free of costs and a great aid for those patients seeking advice to start their journey.

Frequently Asked Questions

Research & Education in Hairline Feminization Surgery

Facialteam’s R&D group has established a new framework of modern protocols in FFS of the forehead and hairline. For us, advancements in science translate into offering our patients the very best in facial gender surgery, with natural looking results and quicker recovery times.


This technique is based on several scientific articles produced by our group throughout our clinical practice. Our academic literature is a record of our dedication to the science of feminization surgery of the upper facial third since 2008.

Logo of PRS, Plastic and Reconstructive Surgery.

Facial Feminization Surgery: Simultaneous Hair Transplant during Forehead Reconstruction

Luis Capitán, Daniel Simon, Teresa Meyer, Antonio Alcaide, Alan Wells, Carlos Bailón, Raúl J Bellinga, Thiago Tenório, Fermín Capitán-Cañadas
After the forehead, the hairline pattern is the second most important feature of gender identification within the upper third of the face. This article describes a new surgical sequence in which reconstruction of the frontonasoorbital complex and redefinition of the hairline by means of an autologous hair transplant are carried out during the same operation.
The Journal of Craniofacial Surgery logo

The Upper Third in Facial Gender Confirmation Surgery: Forehead and Hairline

Luis Capitán, Daniel Simon, Carlos Bailón, Raúl J Bellinga, Javier Gutiérrez-Santamaría, Thiago Tenório, Fermín Capitán-Cañadas
Surgical modification of the frontonasoorbital complex is reliable and predictable, and also delivers satisfactory results that are stable over time. A prototypical male hairline has an M-shaped pattern compared to the more rounded shape often seen in female hairlines.
Best Paper Award & Plastic and Reconstructive Surgery Journal logos

Facial Feminization Surgery: The Forehead. Surgical Techniques and Analysis of Results

Luis Capitán, Daniel Simon, Kai Kaye, Thiago Tenório
This article describes the main surgical techniques used in feminization of the forehead complex, sequences the different steps in forehead reconstruction, evaluates results obtained using cephalometric analysis, and includes the level of patient satisfaction.