What is Wrong with Joe Biden’s Hair Transplant?

Mr. Joe Biden before and after hair transplant - Left: young Joe Biden with early male patterned baldness, Right: after hair transplant
Joe Biden before and after hair transplant: Left: young Joe Biden with early male patterned baldness. Right: Joe Biden post-hair transplant

Joe Biden Before And After Hair Transplant

Originally Posted November 4, Updated July 23, 2020

Joe Biden is no stranger to the public or to our blog. In November 2013, we discussed the issues with his famous “hair plugs” (see below). Now that Biden will be running against Donald Trump in the fall, his hair transplant (along with additional plastic surgery procedures) is often a topic of discussion and the subject deserves an update for fans of politics and celebrities.

Supply and Demand Mismatch of Hair

Several years ago, I had a conversation with a 31-year-old patient of mine that was insisting on having a hairline that was low and broad. During a close evaluation of his hair loss and hair transplant pattern, as well as a microscopic evaluation of his scalp, I noticed he had significant miniaturization throughout the top and crown area of his scalp. This was clearly a sign that he was heading towards Class VI or VII of hair loss which means he will eventually only have a rim of hair around the scalp.

I informed the patient that, when I design a hairline, I have to take the progress of hair loss over time into consideration. A good hairline is one that looks good now and will also continue to have a natural look when the person is in his 60s or 70s (unlike both Joe Biden and Donald Trump).

Hair Line Positioning

The hairline of Mr. Biden is an example I use when I have to plan for a higher hairline for younger adults. Many of these younger patients have hopes of achieving a lower hairline which is possible when there is no evidence of advanced hair loss.

When I see microscopic evidence of a future class of hair loss or a patient has a significant family history of high-grade baldness, I have to be more conservative in my approach in order to avoid any issues that can be seen in people with hair loss like Joe Biden.

Two problems with Mr. Biden's hair transplant - Right: Wide area of crown with no coverage - Left: Thin hair on a large area of top
Two problems with Joe Biden’s hair transplant: Left: Thin hair in a large area on top of the scalp. Right: Wide area of the crown with no coverage.

Joe Biden Hair Transplant Problem Areas

  • Poor design and poor long-term planning
  • Hairline that is too low for someone with advanced hair loss
  • Hairline that is too broad for this stage of hair loss
  • Lack of sufficient hair to restore the crown
  • Large balding area that needs more coverage
  • Not enough donor grafts to cover the crown

By keeping the hairline higher as well as creating the appearance of some corner recessions, a natural look is created for the hairline. This is helpful in the long run because, even if the patient loses the crown and has no intention of restoring it, a higher hairline usually goes hand in hand with a balding crown so there is not an unnatural look to the hairline.

Do I Have to Shave My Head Before a Hair Transplant?

do i need to shave my head for a hair transplant?

Q:

Hi Dr. Mohebi,

I am planning to undergo an FUE hair transplant to add greater density to my hair in the front and along the hairline. Do you always shave the patient’s hair before a hair transplant? Is there a way it can be performed with long hair?

A:

Thanks for the question.

It is usually not mandatory to shave a patient’s head before an FUE procedure. Both types of hair transplant (FUE or FUT/strip) can be performed with minimal or no shaving.

  • In the strip method, shaving can be limited to the area of the strip that will be removed so the patient will have long hair on both sides of the wound so it will be covered. With the FUE method, the donor shaving can be done in layers which means the longer neighboring hair can cover easily cover the shaved area. Layer shaving in FUE transplant can only eliminate the appearance of a shaved head if you leave your hair longer on the back and sides. We recommend complete shaving whenever possible since it allows us to expand the donor area to the entire permanent zone. That increases the evenness of the hair on the donor area and avoids the minimal contrast between the extracted and neighboring areas with higher density.

Shaving the donor area in layers allows us to harvest up to 2000 grafts in one day. However, it might not be possible to harvest more than that amount. For larger sessions, we need to have access to the entire donor area so shaving in layers might not be possible.

  • We offer Celebrity Hair Transplant (non-shaven FUE) so the patient doesn’t need to have any shaved areas on the donor or recipient area. This procedure is more labor intense so fewer grafts could be transplanted in each session and it is more expensive for the same reason.Celebrity Hair Transplant is popular among celebrities who do not want any evidence of a hair transplant (even in the first few days after the procedure). This hair restoration technique allows the surgical team to either excise the grafts with long hair or cut only the hair that needs to be harvested so there is no visible shaved area on the back of the head.

Do I need to shave my head for a hair transplant?

Non-Shaven FUE – FAQ With Dr. Mohebi.

Do you have a question for Dr. Mohebi? If so, Contact Us today!

Doctor’s Review: Hydrobrush for Minoxidil Treatment

If you have ever had to use minoxidil, or other hair loss treatment serums, you have intimate knowledge about how frustrating it can be to apply the treatment to your scalp. There are times when it seems that more of the medication ends up in your hair instead of actually on your scalp where it is supposed to be applied.

Thanks to this easy to use, new product called a Hydrobrush, you can say goodbye to the frustration of having to use your fingers or sprays to apply minoxidil or other hair loss treatments! You will no longer have to deal with a messy, wet or greasy look when you are applying a hair loss treatment on your scalp.

What is the Hydrobrush?

The Hydrobrush is a fantastic innovation that is ideal for delivering minoxidil or other serums to the scalp. This gel-dispensing hair brush is designed to be filled with minoxidil so it can deliver the treatment through the tips of the brush. The minoxidil easily flows from the tips of the brush directly to the targeted areas of the scalp.

Watch the informative video below as Dr. Parsa Mohebi shows you how to properly use the Hydrobrush on your scalp. The video will give you the tips you need to accurately and effectively apply minoxidil to your scalp in the best way possible.

If you have any further questions or concerns when it comes to using the Hydrobrush, please feel free to contact us. If you are ready to put the product to work on your scalp, you can purchase the Hydrobrush by clicking here.

– MA

Did You Know Some Illnesses Can Cause Hair Loss?

A large number of people suffering from hair loss think the main cause of the condition is genetics. While genetics does play a part in hair loss, it is not the only reason a person might be suffering from a lack of hair on their scalp. Here are three illnesses that can result in hair loss:

  • Crohn's IllnessCrohn’s Disease – This disease is a severe inflammation of the gastrointestinal tract. Along with other inflammatory bowel diseases, Crohn’s can result in hair loss because it limits the absorption of essential nutrients through the area known as the gut. Vitamins and nutrients are absorbed through the gut wall in a healthy person so they can be delivered around the body. Crohn’s prevents the absorption from happening, which can cause hair follicles to stop the regeneration process and move into a shedding phase. Fortunately, the hair loss caused by Crohn’s will reverse once the disease goes into remission.
  • Thyroid Disease – Both over-active and under-active thyroids can cause hair loss. The thyroid is a glad located in the neck that creates and releases hormones in the body. The hair loss occurs due to the changing levels of hormones in the body having an impact on the natural cycle of the hair follicles.
  • Scalp Infections – There are some infections that can attack the skin as well as the hair on the scalp and result in hair loss and scaly patches. A good example of a scalp infection that does this is ringworm. However, once the infection causing the hair loss is treated, the hair generally grows back.

Patients who think their hair loss might be the result of a disease or an infection should schedule a consultation with a board-certified doctor. The physician will perform a thorough examination and determine the cause of the hair loss as well as the best method of treating and restoring the hair.

What Group Of Men Is More Likely To Go Bald?

Men Hair Loss StudyIt’s been said that hair loss doesn’t discriminate and that it can impact almost anyone. However, a study earlier this year suggests there is one group of people who might be more likely to have some amount of hair loss.

Who is this group of people???

According to research published earlier this year in Nature Communications, white men on the shorter side of the size spectrum might have a greater chance of male hair loss than other men. The research studied and identified genetic associations among such factors as greater rates of premature hair loss, earlier occurrences of puberty, reduced body size and some cancers.

The authors of the study used a global group of 12,000 men without hair loss and 11,000 men who have premature baldness. According to Dr. Stefanie Heilmann-Heimbach of the University of Bonn, “We were thus able to identify 63 alterations in the human genome that increase the risk of premature hair loss.”

In the same press release that quoted Dr. Heilmann-Heimbach, Professor Markus Nothen, director of the Institute of Human Genetics at the University of Bonn, noted that the analysis of genetic associations also pinpointed links that exist between light skin color, increased bone density and premature baldness. Dr. Nothen said that the links indicated that males with hair loss are better equipped to use sunlight as a way to synthesize vitamin D and that it could also explain why white males seem to lose their hair more prematurely than other men.

Despite their findings, the research team did say that additional studies will need to be conducted before any final conclusions can be made regarding shorter white males being more prone to hair loss.

Can Science Predict Male Hair Loss Patterns?

Male Hair Loss PatternA group of researchers at the University of Edinburgh have come to the conclusion that the genetic process of hair loss involves 287 genes. Furthermore, they also say they have come up with a formula that predicts the risk a man runs of losing his hair. Even with this formula, the team says it is still too soon to predict whether or not a blood test can show if, and when, hair loss will begin for a man.

According to an article published in the peer-reviewed open-access journal, PLOS Genetics, the results of the study might be able to help identify males at a larger risk of hair loss. If the men are able to be identified, they might also be possible “genetic targets” to help prevent any possible hair loss by intervening before it
occurs.

According to Ricardo Marioni and his University of Edinburgh research colleagues, the total of 287 genetic signals linked to the process of hair loss was determined after the researchers studied DNA from a group of more than 52,000 men who count as being middle-aged. The men took part in a large genetic experiment in Britain called BioBank.

A student involved in the project, Saskia Hagenaars, said the study was successful in identifying hundreds of new genetic signals. Hagenaars also said that many of the genetic signals involved in the process of male pattern baldness actually came from the X chromosome which is inherited from mothers.

The study group included 16,700 men with no hair loss and an additional 12,000 with a slight case of hair loss. In addition, the study included 14,000 men with moderate hair loss and 9800 study group members with severe hair loss. The research team linked the genetic pattern of each man in the study with their degree of hair loss. Men in the study group with total hair loss genes that were less than average were not likely to become bald. In this group, 14% of the men were bald and 39% of the group didn’t have any hair loss. On the other hand, 58% of the men in the top 10% of having baldness genes also showed some hair loss. According to the research group, this makes the genetic pattern of hair loss somewhat, but not completely, predictable.

The research team wrote that “male pattern baldness affects around 80 percent of men by the age of 80 years.” Having said that, they still feel that science is not close to being able to accurately predict any hair loss patterns in individual patients. According to Marioni, “these results take us one step closer. The findings pave the way for an improved understanding of the genetic causes of hair loss.”

3 Hair Restoration Techniques Showing Promise For Patients

New techniques are constantly being tested and researched to try and combat hair loss. Some might show promise and be marketed to consumers while others will never get out of the research phase. Here are some techniques currently being studied to help those who suffer from hair loss:

  1. Hair Restoration Techniques for promising resultsHair Multiplication

A partnership between the RIKEN Research Institute of Japan as well the Japanese electronics company, Kyocera, and Organ Technologies is studying the science of hair multiplication for dealing with hair loss. The research team plans to extract the hair follicles of a patient and then multiply them through the use of cell culturing. The multiplied hair will then be transplanted back onto the areas of the scalp that are balding. The process of hair multiplication looks to solve the issue of insufficient donor hair supply on the back of the scalp. The research team is aiming for 2020 as the date for the process to be commercially available.

  1. Skin Perturbation

Follica is a United States company looking to combine skin perturbation (where the top layers of the scalp are peeled back) and topical compounds. The removal of the top layers of the skin prompts the skin cells that are located beneath them to change to a stem-like state. Once this happens, a topical compound is applied to the area to stimulate new hair follicle growth. This technique is designed to work on patients who have already lost their hair. Once the skin is peeled back, the cells in the area make the decision to create more skin or hair. Follica is working on trials with mice and human subjects to try and move the cells in the direction of making more hair. They hope to finish their trials sometime this year and have the technique ready for public use by 2018.

  1. Wnt Signal Reactivation

The biotechnology company, Samumed, released data from the second phase of their clinical trial of SMO4554 in 2016. The data showed information regarding SMO4554 which is a drug applied topically to patients with male pattern hair loss. The drug works by restarting any Wnt signaling pathways that were disrupted. These are the proteins that give instructions to a cell. The idea behind starting the signals again is that hair growth will begin again once normal cell functions have resumed. Samumed plans on starting the next phase of their clinical trials later this year which should give the public a better idea about the viability of the technique.

Clinical Research Study

The FUE Advancement Committee (formerly known as the FUE Research Committee of ISHRS) continues to work towards improvements in the field of FUE hair restoration. Founded by Dr. Mohebi in 2012, the committee includes the most talented hair transplant surgeons across the globe. The committee also continues to create and implement studies designed to fine-tune the techniques and instruments that help improve the quality and end result of FUE procedures.

The ongoing studies are conducted in several countries and in several centers across the globe. Currently, they are performing several studies and are actively looking for participants to take part in the studies.

If you are interested in finding out if you are qualified to take part in one of the studies, please click on the link above for more information. Dr. Mohebi is the lead investigator on “FUE Graft Survival: Implants vs. Forceps” and Parsa Mohebi Hair Restoration is one of the study centers for “FUE vs. Strip Graft Survival”.

You are also welcome to contact our office for more information.

The future of hair restoration will be here before you know it. The staff of Parsa Mohebi Hair Restoration is committed to making sure that our patients, as well as patients across the globe, receive the best care and results possible in the field of hair restoration.