An often overlooked but crucial aspect of facial feminization is the shape and position of the hairline. A feminine hairline is lower down and more rounded in shape against the forehead, framing a shorter forehead with a more rounded face. A male hairline can be lowered into a more naturally feminine height and shape surgically and non-surgically.
Surgical vs Non-Surgical
Dr. DeFatta will make recommendations and discuss options for hairline procedures based upon several factors. As with other areas of facial feminization, the unique anatomy and aesthetic of each patient can vary when it comes to the amount of change needed to achieve your desired look. Therefore, the option for hairline lowering are highly individualized and may be achieved with one or a combination of the following:
- Scalp advancement surgery, often done at the time of a brow lift
- Hair transplantation
- Scalp micropigmentation
Gender confirmation candidates with a naturally higher hairline, with male pattern baldness and/or larger forehead can consider hairline repositioning options. The common goal of these procedures is to shorten the distance between the eyebrows and the hairline, to advance the position of the scalp forward and to round the shape of the hairline. Some of these procedures can be performed at the same time as a larger set of facial feminization procedures, completed under one episode of anesthesia care.
Method of Surgery & Enhancing Procedures
The surgery is performed by making an incision along the natural hairline and then advancing forward the scalp tissue that contains more hair. Individual hair follicles may then be transplanted further feminizing the shape of the hairline and creating a more convincingly natural and wispy feminine hairline.
For some, procedural hair restoration is not an option or is not desired, and this is where scalp micropigmentation (SMP) can be an excellent option. SMP is a medical tattooing technique that can be used to treat areas of thinning hair and reshape the hairline by mimicking the appearance of individual hair follicles. It may be recommended as a standalone procedure or combined with other tools for hairline feminization to enhance the results of other techniques and restore the appearance of general hair density.
What to Expect
Hairline surgery carries with it very manageable post-surgery pain. Swelling is common, located in the forehead and eyebrow area, and can last up to two weeks after the procedure. When combined with a browlift procedure, a light pressure dressing is placed at the end of surgery and Dr. DeFatta will counsel you on how and when to remove it. Numbness around the sites of incisions can occur as well, but typically is only temporary. Sutures may remain in place up to 10 days, especially if placed in the scalp. Dr. DeFatta will counsel you on when you can resume hair washing, and in most cases, you can resume normal activity by about two weeks. Once the healing process is underway, you should expect to notice results in four to six weeks after the procedure.