Root Hair Institute


Have you ever heard the saying that your eyebrows serve as the frame for your eyes? Well, hairlines are the frame of your entire face.

Just like the shape and thickness of your eyebrows can change how your face looks, your hairline is a huge factor in how your face is perceived overall and perceived femininity. So much so that hairline lowering has become a standard part of gender-affirming surgery.

Hairline feminization surgery with hair transplants follows the same processes as other types of hair transplants. It just uses the hair follicle grafts to lower and adjust the shape of your hairline.

This allows you to customize your hairline to match your gender identity and compliment your face.

Want to learn more about how hairline feminization surgery is done? Keep reading as we break down its impact and the different procedures involved.

The Impact of Hairline on Facial Appearance and Visual Femininity

Before we get into how hair feminization works and the types of hair transplants involved, why is it so important?

Hairline shape and height are key gender indicators in the face. They play such a big role that even babies use hairlines to differentiate between genders, according to one study.

On average, men’s hairlines tend to begin 6-8 cm above the glabella. This is the area of skin between your eyebrows. In women, hairlines typically begin roughly 5.5 cm above the glabella. This is a significant difference, and it is why men are often thought to have higher, large foreheads. Although biological male foreheads can be larger on average, the higher hairline placement emphasizes this difference.

Besides height, the hairline shape is also a differentiating factor. Male hairlines tend to have more recession with recessed angled. This difference accentuates with age as the hairline often continues to recede in males. Hair loss is much more prevalent in males, and 1 in 4 biological men may start losing hair before the age of 21.

Causes of High Hairlines

Although high hairlines are considered a more masculine trait, assigned gender isn’t the only factor. Women can also have high hairlines.

High hairlines can be due to genetics, hormonal factors, or age. They can also be caused by hair care routines, such as very tight hairstyles in traction alopecia.

Prescribed medications that induce hair loss may also worsen hairline recession in both sexes.

Finally, other types of alopecia (hair loss) such as frontal fibrosing alopecia can also cause the hairline to recede.

What Is Hairline Feminization Surgery?

Hairline feminization surgery is an umbrella term that encompasses a variety of procedures to lower and customize the hairline shape. The goals can be to:

  • Reduce the distance between the glabella and the hairline (which creates the impression of a smaller forehead)
  • Reshape the hairline to create a gentler curve rather than a more angular shape

Besides lowering the hairline and softening its shape, hairline feminization surgery can also address hair loss and hairline recession.

There are two main ways surgeons can accomplish hairline feminization:

During hairline/scalp advancement, the surgeon makes an incision along the hairline, effectively pulling it down and creating a visually smaller forehead.

Hair transplant is a less invasive option that takes existing hair follicles and relocates them to create a lower, thicker, and more curved hairline.

In some cases, patients might need a combination of these surgeries. If a combination approach is considered it is often recommended to do the hairline advancement procedure first and then the hair transplant procedure. This is so that the hair transplant can be used to also help cover scar tissue from the hairline advancement procedure.

How Hair Transplant for Hairline Feminization Differs From Other Hair Transplants

Hair transplant to feminize the hairline is very similar to other types of hair transplants such as a crown transplant. However, instead of populating the crown of the head with follicle grafts, it focuses on the hairline.

If you’re experiencing thinning in the crown region or another part of the scalp, you can potentially have both areas addressed during your hair transplant.

Different Hair Transplant Options for Hairline Feminization

Hair grafting with a hair transplant is a highly effective way to address receding hairlines and/or to feminize the hairline.

If you are considering a hair transplant for hairline feminization, it’s important to understand the different types of hair transplants surgeons use.

Currently, there are two primary hair transplant options.

Follicular Unit Transplant (FUT)

Follicular unit transplants involve harvesting a single strip of hair follicles from the donor area of the scalp. This is usually the back and/or the sides of the head as this area tends to be the most resistant to balding or thinning.

After harvesting, the strip is then dissected into individual follicular units under magnification. The individual follicular units are then transplanted one by one into the area where increased hair density is desired.

During the harvesting process, your surgeon will administer local anesthesia to the donor site. Once they have harvested the strip, they will close the scalp incision (usually with sutures) to minimize associated scarring.


Follicular unit transplants often allow a large number of hair follicles to be removed while keeping the donor hair long. Starting with FUT procedures prior to switching to FUE has also been shown to lead to a higher number of grafts available over a person’s lifetime. For this reason, this type of procedure is often chosen in those with long hair (who do not want to shave their donor area) or in those with aggressive hair loss where it is anticipated that multiple procedures will be needed with a large demand for grafts.


One of the drawbacks of FUT is that it leaves a linear scar. If someone may want to shave their head in the future or wants to avoid having stitches, then they may choose FUE over FUT.

As with any other procedure, there is scar tissue but choosing a skilled surgeon and properly following aftercare instructions can improve healing and decrease the amount of scarring.

In someone who may want to wear their hair very short (shorter than 1-1.5 cm) in the back, then they may also want to consider FUE to avoid the linear scar with FUT.

The FUT procedure also often has a longer recovery than with the FUE procedure.

Follicular Unit Excision/Extraction (FUE)

Follicular unit excision was pioneered back in the early 2000s, and it has become increasingly popular since that time.

The primary difference between FUE and FUT is the hair follicle harvesting method. Instead of harvesting a strip of skin, the individual hair follicular units are harvested from the donor area using a specialized punch instrument.

Instead of creating a linear incision and scar, this process leaves behind small dot-shaped incisions and scar tissue.

After harvesting, the hair graft process is the same as for FUT where the individual follicular units are transplanted into areas where increased density is desired one by one.


One of the primary benefits of FUE is the avoidance of a linear scar. FUE typically leaves small white/hypopigmented scars with no hair scattered throughout the donor area.

This is ideal for patients that want to be able to wear their hair in short styles in the back and sides.

Recovery time is also typically faster with FUE compared to FUT.


The transplanted hair in FUE comes from a larger area in the donor area, and thus over many decades some of these hairs may not be as strong as with FUT.

The donor hair also has to be shaved down for most cases especially large cases, so this method is often not preferred by those with longer hair.

Finally, in those with aggressive hair loss where a large total number of quality grafts are desired over someone’s lifetime, starting with FUT may be preferred to allow a total higher number of grafts over multiple procedures.

Which Hair Transplant Method Is Best for You?

The best hair transplant method for you will depend on a few factors, such as:

  • The level of hair loss or hairline recession you have
  • Whether you favor long or very short hairstyles
  • The characteristics of your donor hair including if you have thinning in parts of the donor
  • Your desired results and preferences

The best way to ensure you receive the right hair transplant method for your individual needs is to consult with a surgeon that specializes in both. They will assess your situation, and determine which method is best suited to your goals and hair concerns.

Taking a Holistic Approach to Hairline Health

Depending on your hair concerns, you might also want to take a holistic approach that involves multiple treatments to improve your hairline.

If you do not suffer from any form of hair loss or hair thinning, and merely want hairline feminization, the hair graft process with hair transplant might be all you need.

On the other hand, perhaps you’re looking into hairline feminization surgery because you are dealing with a receding hairline.

Here at the Root Hair Institute, we take a holistic approach to hair rejuvenation. Sometimes, surgery can be augmented by other treatments that can stimulate hair growth and target thinning. These can help decrease further hair loss and strengthen the existing hair. These include treatments like medications, scalp injections, and low-level light therapy.

We also offer scalp micropigmentation to enhance aesthetic hair restoration results.

Are You Looking To Customize Your Hairline to Match Your Gender Identity?

Hair transplant is a way you can feminize your hairline if that is desired to affirm your gender identity. Customizing your hairline can have a powerful impact on your overall perceived facial appearance.

Like with any medical or cosmetic procedure, it’s imperative that you find the right clinic and surgeon.

It is important to find a clinic, surgeon, and team that specializes and focuses on hair transplant. Ideally, the team should be skilled and experienced in both FUT and FUE procedures, so that they can perform whichever procedures are right for your case. It is also important that you feel comfortable communicating with the team.

Our team is focused on hair transplant surgery and providing the best possible results and service to our patients. If you live in the Seattle area (or are willing to travel there for your procedure) and are interested in further exploring your options for hairline feminization surgery, contact us to schedule a consultation.