For the past 20 years we have been offering surgical hair restoration for trans-gender patients, all of whom have been male to female in our practice. This has been an especially gratifying part of our practice. The role it plays in creating a feminine facial appearance is remarkable.
When trans-gender patients first present to us, the degree of hair loss varies greatly from patient to patient. Almost all patients require some lowering of the front hairline with grafting and filling in of the typical male fronto-temporal recessions, along with bringing temple hair forward. To accomplish this we usually use “dense packing” of follicular unit (FU) grafts, a total of 2 sessions a year apart, each consists of 1500-2500 grafts. The graft number is based on how large of an area needs to be filled in. For male-to-female trans-gender patients who have a large U-shaped pattern baldness area, another option is to transplant the front third along with the temple area, and then utilize a small clip-on hairpiece to cover up the back half of the head.
We appreciate the fact that these patients usually have other surgical issues present, in order to accomplish their overall goal for being female, and that these tasks are a fairly substantial financial burden for most.
We spend a fair amount of time in the initial consultation reviewing all of the options, and what the best timing sequence is for them.