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Male to Female Transgender Hairlines as part of Sexual Reassignment Surgery

Hair Transplant in Sexual Reassignment Surgery situations is done only for Male to Female Transgenders/Transexual Males

After appropriate psychiatric assessment which is an essential component when anyone wishes SRS. These patients are usually already on female hormonal supplements with or without DHT blockers like Finasteride (Propecia) or Minoxidil (Rogaine).

Mostly patients in this category present with Grade 2 pattern to our clinic (66.7%) and remaining are – Grade 3 (22.5%), Grade 4-5 ( 7.6%) and Grades 6-7 (3.2%).

Hair Transplant is just one of the many procedures these patients will undergo. Others being- breast augmentation through implants, chin implants, vaginal reconstruction, malar bone reduction, nasal hump reduction and tip-plasty.

There is a higher prevalence of HIV positivity in the patients and hence great care should be taken while surgically handling them.

For the hairline, the following points need to be taken into consideration:-

1. The hairline recession has ceased after stopping hormones and DHT blockers.

2. Prominent temples and widow’s peak need to be designed in consultation with the patient to give a heart-shaped hairline.

3. Since hair loss has stopped due to the elimination of the source of testosterone, higher densities should be achieved. The baldness is not likely to progress any further.

4. To counteract testosterone secreted by adrenal glands, Tab Finasteride should be continued for some more time in those with a strong family history of androgenetic alopecia

Mostly transgender Male to Female hairline restoration is hugely satisfying.

References:
1. Pathomvanich D, Bertram Ng (2008) Laser-assisted hairline placement. Hair Transplant Forum International 18(5)

2. Sheill RC (2004) Hair transplant in the transsexual male.In: Hair Transplantation, 4th edn. Dekker, New York, pp 602-606

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