Facial hair indicates masculinity for many people. Growing a beard is often one of the first things trans men want to do as they transition. But growing a beard doesn’t come easily for everyone, whether they are cisgender or transgender.
Fortunately, a beard transplant can help people naturally grow facial hair, giving them the masculine appearance they seek. If you’re in the process of transitioning and would like more facial hair, here’s what you should know about the beard transplant process and what to expect.
What is Facial Hair?
Whether male or female, the majority of people have facial fair. Sex hormones often influence how thick and prominent the hair is, which is why men tend to have thicker, darker, and longer facial hair. Genes also play a role in determining how thick and visible the hair is.
Some people have light, downy hair on their cheeks and upper lip. Others have thick, dark hair or even a full beard.
For people assigned male at birth, puberty usually triggers the growth of prominent facial hair. An increase in the hormone testosterone stimulates this hair growth.
Facial hair usually grows in a specific pattern, with hair above the upper lip appearing first, followed by the hair on the sideburns, then chin hair, and finally, cheek hair. Some men also grow hair on their necks.
How much facial hair a person will grow largely depends on the number of hair follicles on their face, according to Gillette. The number of hair follicles is in many ways determined by genes. Some men naturally have fewer facial hair follicles than others.
What Influences Facial Hair Growth in FTM Patients?
Hormones and genes help to determine how much facial hair growth an FTM person will experience. If you have siblings or parents who naturally have full, thick beards and mustaches, the odds are likely you will be able to easily grow facial hair after transitioning.
Hormone replacement therapy (HRT) can also kickstart beard growth in FTM patients. Taking testosterone essentially starts a second puberty, which may allow for new hair growth.
Although some patients do experience an increase in facial hair as a result of taking testosterone, not everyone does. It’s also important to remember that some people can see facial hair growth without taking hormones.
What Is a Beard Transplant?
If you are having difficulty growing facial hair on your own, a beard transplant can be an option to help you get the full, thick facial hair you want.
A beard transplant is a type of hair restoration procedure. It takes hair from one area of the body, like the scalp, and transplants it into another, such as the cheeks or chin. The transplanted hair permanently grows in the new location.
The transplanted hair is harvested from the patient’s own body, so there is little risk of rejection. Often, sources for the harvested hair include the sides or back of the head.
Once the hair is harvested, it won’t grow back in the source area so it’s important to remove hair strategically. Usually, there is enough hair remaining from the harvested location that the missing hairs aren’t visibly obvious.
Beard Transplant Methods
A hair restoration surgeon might use one of two methods when performing a beard transplant. The type of procedure they will perform depends in large part on the number of follicles needed to reach the patient’s goals.
Follicular Unit Transplantation (FUT)
Follicular unit transplantation is also known as follicular unit grafting (FUG) or the “strip” method. When using the FUT method, a surgeon will cut away a strip of hair from the back or sides of the scalp, according to Healthline.
The strip is small, usually no more than 1.5 cm in width. Its total size is based on the number of follicles the surgeon needs for the transplant.
After removing the strip of hair follicles, the surgeon will stitch the opening in the scalp closed. A thin scar will remain at the site of the incision after it’s healed.
The surgeon then carefully transplants the harvested follicles into the facial skin, depending on the beard restoration goals of the patient. They’ll place the follicles in a pattern that looks natural and that matches the pattern of existing facial hair as much as possible.
Follicular Unit Extraction (FUE)
While FUT is still used from time to time, it has largely been replaced by follicular unit extraction (FUE). Unlike FUT, which requires harvesting a strip containing thousands of hair follicles, FUE harvests the follicles individually.
To extract the hair follicles, the plastic surgeon uses a small drill, also known as a micro punch. The tool creates a small hole in the area around the follicle, pulling it out but leaving it intact.
Since FUE removes each follicle group one by one, it can be a more painstaking process compared to FUT. The procedure leaves only tiny scars, though, which can be ideal for people who want to wear the hair on their head short.
Once the follicles are harvested, the process of FUE is similar to that of FUT. The surgeon will transplant the follicles into the areas of the face where the patient wants to grow a beard.
Source of the Donor Hair
One of the key features of a beard transplant is that the hair needs to come from the patient’s own body. If the hair came from another source, such as a sibling or an anonymous donor, the person receiving the transplant would need to take immune-suppressing drugs, according to WebMD.
The back and sides of the head are common harvest areas for a few reasons. Usually, the hair that grows in those areas is resistant to the hormone that triggers male pattern baldness. There also tends to be an ample amount of hair in those areas.
If you don’t have a lot of hair on the sides or back of the scalp, you can talk to your surgeon about other potential donor sites, such as the arms or legs. The amount of hair you have available may affect your candidacy for the procedure.
Risks of a Beard Transplant
Like any type of surgery, a beard transplant has some risks and the potential for complications. Incisions can become infected and the resulting scar can be very prominent, particularly if the surgeon used the FUT method.
It’s also likely that there will be some swelling in the harvested and transplanted area after the surgery. Some men might notice bleeding or crusting of the follicles. Following your surgeon’s instructions before and after the transplant will help to reduce the risk of infection, bleeding, and other side effects.
What to Expect During a Beard Transplant
Before the transplant, talk to your surgeon about how you’d like your beard and other facial hair to look. They’ll draw the pattern on your face to use as a guide when transplanting the donor hairs.
You might also have a discussion about which donor hairs will work best for your new beard. Depending on the color and texture of existing facial hair, your surgeon might use the hair from your scalp or they might recommend hair from another part of the body.
Once the design is chosen and the donor site is selected, the surgeon will begin the process of harvesting the hairs. You’ll typically be given a local anesthetic to numb the donor area and might also receive an oral sedative.
After harvesting the follicles, the surgeon will prep them for transplantation, then position each one in the facial area. All told, the beard transplant takes anywhere from two to eight hours, depending on the number of grafts.
What to Expect After a Beard Transplant
Your surgeon will send you home with a list of instructions for the recovery period after the transplant. You’ll most likely be told not to get the area wet for a few days and to take it easy for about a week. You can usually expect to see some swelling and redness in the face after the procedure.
You won’t have a full beard immediately following the transplant. In fact, be prepared for the transplanted hairs to fall out after a few weeks. Shedding of the transplanted hairs is normal and expected. Typically, new hair growth will begin a couple of months after the surgery.
How to Care for Beard Hair
Once your new beard starts growing, you can expect the growth to continue long-term. You’ll want to treat it with the same care and attention you give the hair on your scalp. In some cases, beard hair might need more attention than the hair on your scalp.
Brush the hair using a natural bristle brush to keep tangles under control and to distribute the hair’s natural oils evenly. Using beard oil or balm will help to keep the hair soft and smooth. You’ll want to trim the beard from time to time to keep it tidy and looking good.
Yes, the donor hair should be from your own body. You’re likely to reject hair from another source.
If you would like facial hair, have started taking testosterone, and aren’t noticing an increase in facial hair, a beard transplant might be appropriate. If your hair growth is patchy, a beard transplant can help you get more fullness. Also, keep in mind that your hair might just need time to grow.
Minoxidil, or Rogaine, can help hair to grow thicker and fuller but isn’t recommended for use on the face.
Some FTM patients see an increase in facial hair once they begin HRT.
The transplanted hair does usually fall out a few weeks after the hair transplant. But the follicles remain intact and new growth usually begins within two to three months.
The number of grafts you will need depends on the size of the area and your facial hair goals.
Yes, you can shave and groom your beard however you’d like starting about 10 days after the surgery. Shaving won’t remove or disrupt the hair follicles.
If you’re considering a beard transplant to create a more masculine appearance, Dr. Anthony Bared can help. Dr. Bared is a hair restoration specialist and facial plastic surgeon in Miami, Florida. To learn more about the beard transplant process and to see if you’re a candidate, call 305-921-9646 or book a consultation online today.