HAIR TRANSPLANT
CONSULTATION SINCE 2004

Women Hair transplant

Andreas Krämer Hair4life

ABOUT THE AUTHOR

ANDREAS KRÄMER

Hair loss sufferer, consultant since 2004, co-author of the book “Hair Transplantation Guidebook” by Alliance4Hair, founder of Propatient with lawyer Chr. Bomke, co-founder of the HTTC training center for doctors. Known from SWR, SAT 1, ZDF, Spiegel and many others.About Us

women Hair transplant against hair loss

Women can also have hereditary hair loss and consider hair transplantation. When thinking of baldness, many people associate it primarily with men. However, the female sex is also increasingly affected by hereditary (androgenetic) hair loss. Many suffer greatly from the consequences of hereditary hair loss, because hardly any woman wants to settle for a thinning hairstyle/hair situation or increasingly large receding hairline. Read here how a hair transplant with the FUE or FUT method can provide fuller hair, eliminate corners and even a high forehead and what the costs are for a procedure.

Female hair loss in general

Female Hair loss and thinning hair in the middle parting before and after a density increase through a hair transplant
Hair loss and thinning hair in the middle parting before and after a density increase through a hair transplant

Hair loss is usually hereditary, although it can also be caused by illness (e.g. diabetes, thyroid disease, etc.) or hormonal changes. As a result, hair often becomes thinner and also falls out – “thinning out”, as FOCUS also reports regarding hair loss in women.1

However, the pattern of hair loss tends to follow the “Ludwig course” (Ludwig scale). The first signs are therefore usually in the crown region, above the ears, or thinning at the hairline of the forehead. Often, treatment with medication can help, e.g. dermatologists like to prescribe the active ingredient Minoxidil. If this does not have any effect, you can expect help from a female hair transplant! In this case, the planning and procedure is somewhat different; in many cases, comparatively greater hair density leads to the best aesthetic result. However, the results can be just as convincing as with men.

By the way, the reasons for hair loss in the female sex are very complex and it often requires a detective approach to actually get to the bottom of the real causes.

Here is an overview of some of the causes:

  • Diseases of the skin
  • Iron deficiency
  • Problems with the thyroid gland
  • Pregnancy
  • Psychological stress
  • Taking medication
  • hormonal changes

Why are more and more women opting for hair transplants with the FUE or FUT technique (strip removal)?

Especially for women, aesthetics is often an important issue. A very important factor for an attractive appearance for women is strong and full hair. Beautiful full hair also stands for femininity. However, along with the hair, a piece of femininity and attractiveness is often lost, which is the most common reason for considering a female hair transplant with the FUE hair transplant or FUT technique (strip removal).

The good news:

Of course, the female gender can also undergo hair transplantation and surgical hair thickening, as recently also reported, for example, by Gala Online about Kim Gloss’ transplantation.2

However, the prerequisite for this is: A confirmed diagnosis of androgenetic alopecia (hereditary hair loss, AGA) and a well-preserved hair crown!


Hair transplantation women statistics: How high is the proportion of female clients for hair surgery?

HAIR TRANSPLANTATION WOMEN STATISTICS: HOW HIGH IS THE PROPORTION OF FEMALE CLIENTS FOR HAIR SURGERY?
Statistics -Source ISHRS 2020 Practice Census Results

In 2019, the proportion of women in all hair surgery procedures performed was 15.8% 3


A hair transplant in women to remove the receding hairline, to have the hairline lowered, or to increase the hair density in still hairy areas

If the diagnosis of androgenic alopecia is confirmed and if there is sufficient hair growth in the donor area, then hair transplantation can be performed.

In a female hair transplant, hair follicles are always “transplanted”, either into existing thinning areas for increasing the density, or into completely bald areas such as into the receding hairline, or to lower a hairline and reduce a high forehead.

In this case, the background knowledge is used that the hair follicles in the donor area are resistant to the harmful male hormones and thus the transplanted hair retains this insensitivity in the new area and never falls out again. The new hair will grow forever and will never fall out again (provided that you do not suffer from an illness at some point and lose your hair as a result, or hair loss as a result of taking medication, etc.).


“Many of the illegal clinics have fancy websites with references and testimonials that look very professional. However, the reality is that many patients have already had a bad experience and the hair transplant may even be performed by someone who has no medical training.”

Read more about the ISHRS.org “Fight The Fight” campaign

Campaign against illegal “black market clinics” World Association for Hair Surgery ISHRS.org


Hair Transplant Women: Two successful result examples

Hair transplantation to increase the density in a thinned out area

Example of a female hair transplant by Dr. Bijan Feriduni: On the left the patient before and on the right after increasing the density
Example of a female hair transplant by Dr. Bijan Feriduni: On the left the patient before and on the right after increasing the density

Hair transplantation of the receding hairline

Hair Transplant Women: 1010 grafts into the receding hairline for filling and increase density Dr. Mwamba
1010 grafts into the receding hairline for filling and increase density Dr. Mwamba

Hair transplantation of a high forehead in women: Forehead reductions through SHA surgery and/or advancement of the higher hairline

However, if you as a woman do not suffer from hair loss and “only” want to reduce a high forehead by lowering the hairline with a hair transplant, then this is of course also an option.

Not only can a deeper hairline and more hair volume be achieved through transplantation, but the female clientele also has the advantage that the status of a fully bald head does not usually occur, and therefore considerably higher densities can usually be achieved.

In the case of a high forehead in women, there is basically the possibility of transplanting one’s own hair, but also of moving the hairline using a surgical intervention and thereby reducing the forehead, a so-called Surgical Hairline Advancement – SHA (surgical hairline advancement) or the procedures can also be combined, as shown in the example of Dr. Feriduni, or also in the repair example of Dr. Feriduni.4

What is SHA?

SHA is a one-step procedure that allows the entire forehead hairline to be advanced by 1.5 to 5 cm through a trichophytic (hairline) incision. The advancement of the hairline allows for the corresponding removal of the forehead skin, thus shortening the height of the entire forehead. The extent of the lowering, the virtually immediate result and density of the advanced hairline, as well as the ability to aesthetically raise the eyebrows if desired, compares favorably to autologous hair transplantation.5 It was first popularised by Dr Sheldon Kabaker,6 but a decreasing number of hair surgeons are familiar with it, possibly due to the success of follicular unit transplantation and the move to minimal surgery.7

To be a good candidate, according to Dr Jeffrey Epstein and Dr Ashlin Alexander of New York, USA, the patient must have sufficient scalp mobility to achieve the desired degree of advancement, good frontal hair density, and no history of previous scalp surgery, such as a brow lift, that could compromise healing.5 A stable frontal hairline is an absolute must, as progressive hair loss could expose the incision scar at the hairline. In addition, these unstable hair along the hairline are particularly susceptible to shock loss, undoing the gains made by advancement.5


Would you like to be socially fit again quickly after your hair transplant?

Read more about Unshaven surgery for women and men!
Hair Transplant in Women without shaving

High forehead and example of a combination of surgical forehead reduction with SHA and subsequent strip hair transplantation with 1790 grafts by Dr. Bijan Feriduni: Video and pictures


Video


Pictures

High forehead in women: Example of combination surgical forehead reduction followed by strip hair transplantation with 1790 grafts - front view - Feriduni
High forehead in women: Example of combination surgical forehead reduction followed by strip hair transplantation with 1790 grafts – front view – Feriduni
High forehead: example of combination surgical forehead reduction followed by strip hair transplantation with 1790 grafts - view from left - Feriduni
High forehead: example of combination surgical forehead reduction followed by strip hair transplantation with 1790 grafts – view from left – Feriduni

Repair case of Dr. Bijan Feriduni: Combination of SHA-lift, scar correction, and aN FUE without shaving – shaving of the receiving zone and strip shaving in the donor

A good hair transplantation requires a lot of experience and fine work! In the case of a female hair transplant, there are some additional necessary experiences, such as experience regarding design and the formation of female hairlines.

If the hairline is “designed” incorrectly in a female hair transplant and other mistakes are made, such as the new hair being placed in the wrong direction of growth, or if too many follicular units with several hair are transplanted in the front at the base (multiple FUs) and if, on top of that, only an insufficient density is transplanted (not transplanted with Dense Packing ), then – as experience shows – the results in women can end in an aesthetic disaster and, above all, in a long period of psychological depression for the patients concerned. Because especially for female patients, aesthetics play an important role and the aim was to improve the hair situation, the desire for more beautiful fuller hair, a deeper, natural, and dense hairline, and a more attractive and better overall appearance.

However, if a poor result is achieved with a transplantation by an insufficiently experienced doctor, then the disappointment is great, one is downright desperate and the patients often go psychologically on the gums for months

Below we would like to present a repair case of Dr. Bijan Feriduni (German doctor), a 32-year-old patient who had had a very bad experience before the repair:

The experience of a Caucasian 32-year-old woman: Repair of a bad hair transplant with the combination of a surgical hairline shift with SHA, correction of the scar and filling of the hairline, and receding hairline with FUE without shaving (shaving) the recipient area

Key data of the patient

  • Patient 32 years old and from Caucasus
  • 2 performed surgeries with the FUT method and bad experiences at another clinic
  • Donor density of 84 FU/cm2 occipital, 84 FU/cm2 parietal, 76 FU/cm2 temporal
  • Hair diameter of ~ 52-62 micrometres

Treatment plan

  1. SHA lift to lower the hairline and extract the misplaced and misaligned FUs from the previous hair transplants in the hairline and secretive corners
  2. Follicular Unit Extraction (FUE) into the hairline and receding hairline to achieve an aesthetic reconstruction of the hairline
  3. Scar correction of previous bad FUT procedures with Trichophytjc Close

Procedures performed

1. SHA lift + removal of misaligned and misplaced grafts(25 February 2019)

2. Scar correction with Trichophytic-Closure closure technique + FUE (Follicular Unit Extraction) with 1581 FU (14 August 2019) Follicular Unit Extraction without shortcutting/shaving of existing hair in the front and with a small strip shave in the donor area, with 1581 grafts/FU`s of which 639 single hair grafts, 613 double hair grafts and 329 triple and quadruple hair grafts, follicular density of grafts on average 1.9

Parallel incisions with the custom-size blades technique.

Extraction using the WAW system with a 0.85 mm serrated trumpet punch

The surgery was performed by the Hairforlife cooperation clinic Feriduni Hairclinic in Hasselt, Belgium

The women’s repair hair transplantation by Dr. Feriduni as video and in pictures


Video


Pictures

The female patient before the correction hair repair
The female patient before the correction hair repair
Before the corrective women hair transplant by Dr. Feriduni and after the first two FUT hair transplants with bad experiences: Insufficient density and thicker grafts in the corners and hairline
Before the corrective women hair transplant by Dr. Feriduni and after the first two FUT hair transplants with bad experiences: Insufficient density and thicker grafts in the corners and hairline
The scar of the previous FUT strip hair transplant with poor experience - Before scar correction
The scar of the previous FUT strip hair transplant with poor experience – Before scar correction
The patient one day after the SHA procedure - the surgical hairline shift and removal of some unsightly grafts of the previous hair transplantation
The patient one day after the SHA procedure – the surgical hairline shift and removal of some unsightly grafts of the previous hair transplantation
During the SHA procedure and removal of thick multiple grafts in the corners and in the hairline of the woman
During the SHA procedure and removal of thick multiple grafts in the corners and in the hairline of the woman
The Women Hair Transplant and 1 day after scar correction and FUE of the hairline and receding hairline corners without shaving the recipient area
1 day after scar correction and FUE of the hairline and receding hairline corners without shaving the recipient area
The FUT scar on the left before and on the right directly after the scar repair. Also on the right the receiving area of the further FUE hair transplant with a strip shave
The FUT scar on the left before and on the right directly after the scar repair. Also on the right the receiving area of the further FUE hair transplant with a strip shave
14 days after the scar repair and FUE hair transplantation without short cutting of the hair in the receiving area
14 days after the scar repair and FUE hair transplantation without short cutting of the hair in the receiving area
The result of the women's receding hairline and hairline FUE after 10 months
The result of the women’s receding hairline and hairline FUE after 10 months
The result of the female patient with the FUE procedure and the picture on the far right the result of the scar correction with Trichophytic-Closure closure technique
The result of the female patient with the FUE procedure and the picture on the far right the result of the scar correction with Trichophytic-Closure closure technique
The result of the female FUE repair correction from close up
The result of the female FUE repair correction from close up
The result of the scar correction close up
The result of the scar correction close up
Comparison of before and after the women's repair hair restoration surgery
Comparison of before and after the women’s repair hair restoration surgery

Hair transplantation women and the methods: Comparison of methods FUE and FUT

Currently, there are two techniques in hair surgery that have become the latest standards over the last few years. The main difference between them is the method of harvesting. See the following table to see which technique is best suited for a women’s hair transplant in which case (the table can be scrolled to the left and right depending on the screen resolution):

Hair transplant women method comparisonFUT strip methodFUE hair transplantation (single hair technique)
Harvesting the grafts/follicular unitsIn the FUT technique, the hair follicles are removed in a strip of skin from the back of the head and prepared for distribution under a microscope. By surgically removing a complete strip of skin, 2000 to 4000 grafts (or significantly more, depending on the elasticity of the scalp) can be harvested at once, depending on requirements. The resulting wound at the back of the head is then surgically closed.In the FUE technique (single extraction), the hair roots are taken individually from the donor area, isolated into grafts of 1-4/5 hair, and transplanted into the thinned out areas. Since hair roots are taken one by one, this method requires more time. Also, it is usually necessary to shave at least the donor area, which is disturbing for many women.
Duration of the extractionDepending on the number of grafts, 30 minutes to 1 hourDepending on the number of grafts and depending on the clinic and whether they are harvested manually or with a micromotor, only a few hours or spread over several days
Maximum number of grafts in one sessionDepending on the elasticity of the scalp, the density of the hair and the size of the hairline, and also depending on the experience and size of the team of technicians, 4000-5000 grafts or even considerably more (but considerably less frequently)Depending on the size and density of the hair ring, up to 4000 grafts or even more, but usually spread over 2-3 days by renowned hair surgeons
Shaving requiredNo in the back of the head, no in the area to be transplanted, however, depending on the hair situation, a hair surgeon may recommend shaving in the reception area during the procedureThe back of the head usually yes and the area to be transplanted usually also yes. However, there are now some hair surgeons who at least do without a shave in the recipient area and only shave the hair in the donor area. In the donor area (depending on the number of grafts), either a strip shave (often for women) or a GJ cut (rather only for men) can be performed. Meanwhile, there is also an FUE variant without any shaving, the Unshaven FUE hair transplantation, without shaving in the receiving area plus no shaving in the harvesting area. However, this method is expensive and is only performed by very few hair surgeons.
Who is it suitable for?Basically for women with good scalp elasticity and patients who always wear their hair longer. In men, the minimum hair length required after FUT is 1.2 – 1.5 cm in order to sufficiently cover the linear scar, whereas women usually wear their hair much longer and this is why many still decide on FUT today, despite the linear scar. FUT is also suitable for patients with a large need for donor hair and for patients who do not like to be shaved in the hairline.For women who cannot imagine a FUT strip hair transplantation from the point of view of the procedure, who ultimately do not prefer strip extraction and prefer a minimally invasive procedure.

Women for whom shaving the donor area is OK, or patients for whom the number of grafts is still rather low, e.g. only up to 1500 grafts. In such cases, FUE Strip shaving is often still a good option.
AnaesthesiaLocal anaesthesia always at the site of the operationLocal anaesthesia always at the site of the procedure
ScarsAfter a strip hair transplantation, a linear scar develops. The extent of the scar, the width and thickness of the scar depends on the number of grafts taken, the closure technique, the know-how and experience of the doctor and the elasticity of the scalp, as well as the healing behavior/scar tendency of the patient. If performed professionally by experienced doctors and with good conditions of the patient, scars of only 1-3 mm can remain, which still allow for quite short haircuts. For women, however, the arguments for very short haircuts are often less relevant, which is why, as mentioned above, many female patients still opt for an operation with the FUT procedureAfter an FUE hair transplantation, small, fine, round scars develop which, however, are hardly visible to the human eye when removed professionally. The size and visibility of the scars depend on the know-how and experience of the doctor, as well as the type and size of the harvesting instruments used. Are the grafts removed manually or with a micro motor? If the latter, with a micro motor from which manufacturer and with which punch sizes? For women who probably don’t shave their hair 1-3 mm short anyway, the issue of scars with FUE is generally rather negligible, since, for example, with 1 cm long hair, even bad FUE grafts would probably hardly be visible.
Risk/RisksDonor area: Wider scar which makes it necessary to wear the hair in the crown long (although women generally wear their hair longer). Also the risk of prolonged tightness and numbness

Reception area: Poor growth rate with both methods, unnatural hairline, thick grafts, toilet brush effect, cobblestoning, and pitting

More on this in the chapter Risk/Risks
Donor area: Decimated hair crown and “overharvesting”, moth-eaten and football field appearance. As a consequence, this not only brings visual and aesthetic damage but also ruins the graft reserves in the donor area, with no options for the future. In women, even bad FUE harvesting and overharvesting by very long hair are probably less visible or at least still somewhat concealable, at least not as obvious as in men, but it may be that after a bad FUE hair transplantation no further FUE procedures are possible.

Recipient area: Poor growth rate with both methods, unnatural hairline, thick grafts, toilet brush effect, cobblestoning, and pitting

Read more in the chapter Risk/Risks
When is it possible for women to do sports again after a hair transplant?After a strip hair transplant, patients should not do any sport for at least 14 days and fitness training should ideally be avoided for 2-3 months. Otherwise, the risk increases considerably that the scar will expand and a wider scar will developExperience shows that after a hair transplantation with FUE, one can already start with some sports such as light jogging and cycling after 10 days
Temporary Shock lossBoth methods! Applies to thickening (but can also occur in adjacent areas of 1-3 cm next to the transplanted area):

When women have hair transplants in areas that are still hairy, the stress of the operation, the anaesthetic etc. can cause existing hair to fall into the resting phase, which means that for 3-5 months after the hair transplant you may look slightly worse than you did before the surgery. Temporary shock loss, however, is only “temporary” and after 3-5 months, the situation will gradually improve when the growth of new hair will also slowly start.
Both methods! Applies in case of compaction (but can also occur in adjacent areas of 1-3 cm next to the transplanted area):

When women have their hair thickened in areas that are still hairy, the stress of the operation, the anaesthesia etc. can cause existing hair to fall into the resting phase, which means that for 3-5 months after the hair transplant you may look somewhat worse than before the operation. Temporary shock loss, however, is only “temporary” and after 3-5 months the situation will gradually improve, when the growth of new hair slowly starts.
Permanent shock loss of existing hairBoth methods! Applies in case of compaction (but can also occur in adjacent areas of 1-3 cm next to the transplanted area):

When women have their hair thickened in areas that are still hairy, the stress of the operation, the anaesthetic etc. can cause existing hair to fall into a resting phase, which means that 1. for 3-5 months after the hair transplantation you look slightly worse than before the operation (as with temporary shock loss), but 2. in the case of permanent shock loss, however, the hair is so traumatized by the stress of the operation, the anaesthetic etc. that they are damaged forever. The risk is all the higher the thinner the existing hair has already become due to hereditary hair loss. Unfortunately, it is not possible to predict how sensitive the already thinning hair is in the respective women and whether they will survive the operation or not.
Both methods! Applies to thickening (but can also occur in adjacent areas of 1-3 cm next to the transplanted area):

When women have their hair thickened in areas that are still hairy, the stress of the operation, the anaesthetic etc. can cause existing hair to fall into the resting phase, which means that 1. for 3-5 months after the hair transplantation you look slightly worse than before the surgery(as in the case of temporary shock loss), but 2. in the case of permanent shock loss, however, the hair is so traumatized by the stress of the operation, the anaesthetic, etc. that they are damaged forever. The risk is all the higher the thinner the existing hair has already become due to hereditary hair loss. Unfortunately, it is not possible to predict how sensitive the already thinning hair is in each woman and whether or not it will survive the surgery.
When will women be able to socialise again after the hair transplant?Depending on the shave, a 14-day leave of absence is generally recommendedDepending on the shave, a 14-day leave of absence is recommended for this method as well. If there is enough remaining hair and if this is not shortened and thus the cover for the traces after the surgery (redness/crusts) is possible, then it may be possible to return to work less than one week after the operation or it may even be possible to return to work one day after the operation without anyone being able to recognize a surgical intervention (for example, this may be possible in the case of a receding hairline hair transplant)
Hair transplant women method comparison

The cost of hair transplantation depends on the area and number of grafts

Ultimately, the costs and prices depend not only on the respective technique (whether > FUE or> FUT ( strip surgery) and the respective clinic, but also on the necessary number of grafts, and the number of grafts depends on the following points, among others:

  • What goals have I set for myself as a woman for the hair transplant?
  • How high/low should my new hairline be?
  • How large is the area that is to receive new hair? Is it only a matter of receding hairlines, or is it a matter of lowering a complete hairline or even thickening larger areas?
  • What density is to be achieved?

The exact number of grafts to be “transplanted” in women also depends:

  • The characteristics of the donor hair (band of hair). This means the density of in the donor area, the diameter of the hair shaft, the color of the hair (the contrast between the scalp and the hair), and whether the hair is curly, wavy, or straight.

Cost examples per graft per transplant technique

Costs for FUT (strip & FUI) – depending on country and number of grafts:

From 1.80 euros per graft in countries like Cyprus, Turkey, otherwise up to 3.50 euros per graft

Prices for FUE (FUE & FUI) – depending on country and number of grafts:

From 1.95 euros per graft in countries like Cyprus, Turkey, otherwise up to 5 euros per graft per graft

Click here for a detailed article about the costs.

Hair restoration surgery for women and general questions and answers

Time curve: Start of growth of the transplanted grafts after hair transplantation for women
Time curve: Start of growth of the transplanted grafts after hair transplantation for women

More examples of female hair transplantation

Before and after pictures

Women hair transplant with 1696 grafts in the hairline and receding hairline Dr. Feriduni
1696 grafts in the hairline and receding hairline Dr. Feriduni
Female hair transplant example from Dr. Lars Heitmann
2500 grafts Dr. Heitmann
Female Hair Restoration by dr. feriduni with 4650 Grafts
4650 grafts Dr. Feriduni
Women fue hair transplantation from Dr. Patrick Mwamba with 1000 Grafts
1000 grafts Dr. Mwamba

Hair transplant women before and after videos

Example: Female client with 1982 grafts transplanted into hairline and high forehead by Dr. Bijan Feriduni

Hair transplant women second example: 2044 grafts in the high forehead by Hairclinic Feriduni

Third example of a hair transplant in an African female patient with a high forehead and 2744 grafts by Dr. Patrick Mwamba

Fourth example: This patient has a total of 1715 grafts transplanted by Hattingenhair.


Sources/References/Author/Co-Authors

1 Focus.co.uk

2 Gala.co.uk

3 ISHRS Practice Census Results Published 2020

4 HRN: Repair Dr. Feriduni SHL Lift, Scar Correction and FUE in 2 sessions

5 https://www.ishrs-htforum.org/content/23/1/12

6 https://pubmed.ncbi.nlm.nih.gov/19289679

7 https://www.ishrs-htforum.org/content/22/6/213

8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825128/

Author

Andreas Krämer/Hairforlife Expert Editorial Team

Co-authors/sources (pictures/videos/information)/review

Many thanks to Dr. Bijan Feriduni, Dr. Patrick Mwamba and the Hairlineclinic for the close cooperation!