Transgender Hair Transplant

The shape and position of male and female hairlines are an important gender trait. Although male pattern hair loss is unwanted for most men, it can be particularly distressing for trans women since it serves as a physical sign of an undesired male phenotype. A receded hairline or a bald spot in the crown may pose a significant issue when completing a male to female appearance.

Certainly, hairpieces or wigs can be worn to cover this male pattern baldness, but these “solutions” are simply not the permanent solution most people want. Most trans women want their own growing, real hair in a fashion and style that aligns with their desired gender and taste.

Difference between male and female hairlines

Understanding the difference between male and female hairlines is of critical importance in hair transplants for both women and trans women as this is necessary to create a natural appearance.

The principle of hair transplantation

Simply put, a hair transplant takes hair from an area where you have a sufficient amount of it, and transfers it to an area where you don't have enough of it. It’s typically taken from the back of your head but can also be taken from other parts of your body.

The newly transplanted hair will shed after some weeks, but the transplanted hair roots will grow new hair within 3-6 months.

The technique we use at 2pass Clinic is the no-shave follicular unit extraction (FUE).

Feminizing the hairline with hair transplants.

How many hair grafts do I need?

The average male needs 2,000 to 3,000 grafts and the average female needs 300 to 500 grafts. Each graft can contain anywhere from 1 to 4 hairs. Covering a quarter-sized bald spot requires a few hundred grafts while a larger bald area closer to the size of an open hand may require a few thousand. The only way to accurately determine how many follicles you need to achieve your goals is to meet with a specialist for a consultation and discuss your goals 1-on-1.

Usually 2 sessions are required to achieve a natural looking result (requiring 50 to 60 hairs per cm²). Per session, we can implant a maximum of 40 hairs per cm².

What is the cost of hair transplantation?

Transgender hair restoration needs will vary greatly from patient to patient, so, therefore, it is difficult to provide a generalized cost of transgender hair transplants. The cost will be determined during your consultation.

When will I see the results from a hair transplant?

The results will begin to be apparent 60 days after the procedure. About 14 to 21 days after your procedure, your newly transplanted hairs will begin to fall out, but don’t fear, this is normal. The roots of the hairs are still located beneath the skin, and new strong hairs will begin to grow from them in the coming months. About 6 months after your surgery, about 70% of the follicles will have sprung new hairs. The remaining hairs could take up to a year to fully manifest.

Can other treatments help to boost the results of a hair transplant?

Yes, PRP (platelet-rich plasma) treatment can actually help to improve blood flow and can speed up the healing process. Read all about it on our blog.

Is hair transplant surgery painful?

A hair transplant is not a painful experience according to most patients. Patients are always administered local anaesthetics and antibiotics to ease the discomfort make it a comfortable and relaxing experience. Most patients report the procedure to be pain-free as well as the recovery.

How long does it take to recover from hair transplant surgery?

After the operation: 

• The hair is NOT washed or styled. The hair is still loose so it would just fall out. The skin needs time to grow back together again. 
• You will be given a bandage that must remain in place for at least 1 day. You could go back to work, but we recommend taking a week off to fully recover.

After 2 days:

• You'll have to stop by at our clinic for the first washing. The bandage will be removed cqarefully and your hair and scalp will be washed with with water and a mild shampoo.
• Avoid powerful shower jets but let the water drip gently over your head. Pat dry gently (do not rub). 
• Avoid physical exertion or exercise during the first week as your body needs time to recover. This reduces the risk of injury or bleeding.
• During the healing process, some small scabs may form and you may experience some slight swelling in transplanted areas. If scabs develop, they usually disappear within 7 days.

After about 2 weeks:

• The newly transplanted hair will fall out - this is normal.

After about 3 weeks:

• The following activities can be picked up again: exercising and sports, sunbathing, visiting saunas

After about 2 months:

• The hair can be dyed again.

After about 3 months:

• The new hair will start to grow until about 12 months after your hair transplant. And of course, if you have long hair, the new hair will take a while to catch up.

Aftercare tips

• Make sure your head is positioned higher than the rest of your body so that any wound fluids can be drained away and swelling can be reduced.
• Try to sleep on your back.
• Cooling is allowed, but never directly on the transplanted area. Always try to cool in places where the swelling drops down to.
• Wait a few days after the surgery to wash your hair. Only use mild shampoos for the first few weeks.
• You should be able to return to work or normal activities in about 3 days.
• Don’t press a brush or comb down over the new grafts for about 3 weeks.
• Don’t wear any hats or pullover shirts and jackets until your doctor says it’s OK.
• Don’t exercise for about a week. 
• Don’t worry if some hairs fall out. This is part of the process. The transplanted hair may not grow much or seamlessly match the hair around it for a few months.

Complications

What are the possible side effects of hair transplantation? The most common side effect is scarring. Some degree of scarring cannot be avoided with any procedure. FUE harvesting technique of grafts causes very small, round, and typically white scars in the patient's donor area where the grafts have been removed. With long hair, these are virtually undetectable.

Other potential side effects include:

• Infections;
• Crust or pus drainage around the surgical sites;
• Scalp pain, itching, and swelling;
• Inflammation of hair follicles (folliculitis);
• Bleeding;
• Losing sensation around the surgical sites;
• Visible areas of hair that don’t match the surrounding hair or are noticeably thinner;
• Continuing to lose hair if your hair is still balding.

Frequently asked questions

Frequently asked questions

• Hair transplant before or after FFS?

  We advise having your hair transplants after your FFS. There's a couple of reasons for that. The first is that the incision on your scalp disrupts the blood flow and can cause you to lose hair around the incision. Usually, it's temporary but sometimes it's not. Future transplants can cover this area. The other reason is that the hair transplant can be used to hide any scar tissue. 

• Is it necessary to shave my hair before hair transplant?

  You can choose. We use both the Shave FUE method (= Follicle Unit Extraction with shaving) and the No-shave FUE method (= Follicle Unit Extraction without shaving). It is also called "unshaven FUE", "non-shaven FUE", "U-FUE (or Undetectable FUE)" or long hair FUE. This entails transplanting long hairs. This way no one knows that you have had a transplant. Of course, the No-shave FUE method is more time-consuming and more cumbersome to harvest and implant. Therefore, the price per graft is also higher. We can only implant a maximum of 1500 hairs using the FUE method without shaving. 

• Will my hair regrow if I start using hormones?

  There is a reversal of male pattern baldness in transgender women starting with hormone treatment to a degree dependent on age and likely other factors. Hormone therapy for male-to-female transgender patients with estrogen and spironolactone can not only reduce male-pattern hair distribution but can also reverse previous effects of androgen on scalp hair patterns.

  The mechanism responsible for achieving hair regrowth in transgender women is the suppression of testosterone to normal female levels. 

  Androgenetic alopecia, also known as male pattern baldness, is a process by which hair loss from the scalp occurs in a progressive, predictable pattern. Recent research has proposed that it is a result of the presence of sufficient androgen in a person with genetic predisposition. Without therapeutic intervention, hair loss will become more severe over time.

• Will the long hair fall out after the hair transplant or stay the same length?

  We cut the long hair before reimplanting it. This hair also falls out after 2 weeks. It will start to regrow  3 to 6 months after hair the transplant.

• How long does it take for you to be able to dye the hair after surgery?

  About 2 months after the hair transplant surgery you can dye your hair again.

• What would be recovery time for this?

  After the operation: 

  The hair is NOT washed or styled. The hair is still loose so it would just fall out. The skin needs time to grow back together again.  You will be given a bandage that must remain in place for at least 1 day. You could go back to work, but we recommend taking a week off to fully recover.

  After 2 days:

  You'll have to stop by at our clinic for the first washing. The bandage will be removed cqarefully and your hair and scalp will be washed with with water and a mild shampoo. Avoid powerful shower jets but let the water drip gently over your head. Pat dry gently (do not rub).  In this stage, slight swelling and scabs will form.

  After about 2 weeks: 

  The newly transplanted hair will fall out - this is normal.

  After about 3 weeks:

  The follwoing activities can be picked up again: exercising and sports, sunbathing, visiting saunas

  After about 2 months:

  The hair can be dyed again.

  After about 3 months:

  The new hair will start to grow until about 12 months after your hair transplant. And of course, if you have long hair, the new hair will take a while to catch up.

• How long do you recommend I leave between ffs surgery and a hair transplant?

  We advise waiting 6 months after your FFS to have hair transplants.

• I'm a cis-gender women, can I also have a no-shave hair transplant or is it only for trans women?

  Cis-gender women are more than welcome as well:)

• Can a No shave FUE be performed the day before or after intensive electrolysis?

  This is perfectly possible. You should look op availability in the calendar of electrolysis and hair transplant to find a good match.

• What is a PRP treatment for hair loss?

  Hair thinning or hair loss is caused by poor blood circulation or by a shortage of certain essential nutrients. If you are considering a hair transplant, it can help to prepare the scalp by having PRP treatments done. It improves blood flow, making it easier for the grafts to attach themselves to their new location and for the scalp to recover. In addition, PRP treatments after hair transplant surgery ensure that the grafts develop better and that hair follicles become stronger, ultimately resulting in a thicker head of hair.      If you want to topple hair loss using a preventative approach, the treatment course usually does not create new hair growth, but makes the hair healthier and fuller. The natural hair growth process is also boosted, as the blood flow to the hair follicles is stimulated. PRP treatment courses for hair loss are therefore often successfully used as a preventive measure in the case of androgenetic alopecia.

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