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.

What’s So Funny about Going Bald?

In an extreme case of the pot calling the kettle black, comedian Larry David has stated that professional golfer Jordan Spieth is going to be “wildly bald”. Spieth is 22 years old and has already won two major tournaments this year (the Masters and the U.S. Open). David is the co-creator of “Seinfeld” and the creator and star of “Curb Your Enthusiasm”.  The two men have a few things in common.

larry david going baldSpieth is a professional golfer. David is not only an avid golfer but he is also a big fan of professional golf. Spieth has a rapidly receding hairline. David has already lost a good portion of his hair.

While David is a big fan of Spieth’s ability to handle himself on the golf course, he can’t wait to see how the young golf pro handles a different kind of pressure.  In the latest issue of Golf Digest, David says he is very interested in seeing how Spieth handles seeing all of his hair in the bathtub. David then makes a prediction that Jordan Spieth has only three or four years left before he is “wildly bald”.  How he reacts to the pressure of going bald is of great interest to Larry David. In fact, it sounds like Larry David can’t wait for the day Jordan Spieth loses all of his hair.

How did Spieth react to the comments of Larry David? The young golfer seems to have a good attitude and took it all in stride. In fact, he remarked that David’s comments were funny and there is nothing he can do about his impending hair loss.

We’d like to point out to Jordan Spieth that there is plenty he can do about his hair loss. He made $1.8 million dollars for winning the Masters and the same amount for winning the U.S. Open.  With that amount of money, Spieth can afford any hair transplant procedure he wants in the future.

Just remember Jordan…Your friends at Parsa Mohebi Hair Restoration are here for you.  Give us a call to set up your consultation appointment!

A Look at The Psychology Of Hair Loss And Hair Transplants

One of the things men and women learn while growing up is a full head of hair is a symbol of power and strength.  The loss of that symbol of youth can have a devastating psychological impact on the identity and self-worth of a person.  Hair loss has and its consequences have been studied extensively and some of the reported psychological effects on male patients include:

  • Detrimental impact on their sex life
  • Affected career choices in men
  • Inability to stay competitive in the work place
  • Increased anxiety levels among younger men
  • A higher rate of depression in men with male patterned baldness (1)

While there have been published reports on the psychological impact of hair loss in both men and women, the corrective effect of hair restoration has not been studied until the last few years.  We have conducted a study to evaluate this.  Our motivation for this study came from our observations of the changes in patient’s behavior as well as their overall satisfaction after their hair transplant.

A Unique Study on the Psychological Effects of Hair Loss

In 2008, Drs. Parsa Mohebi and William Rassman conducted a study (2) to quantify the psycho-social impact of hair loss in men with typical male-patterned baldness.  The study criteria were based on a combination of prior studies as well as clinical observations that could be modified by a hair restoration procedure.

Psychology of Hair TransplantA group of patients were picked who have had a hair transplant in the past and they were surveyed the changes they experienced through a questionnaire.  The questionnaires featured queries about these eight criteria:

  • Level of happiness
  • Energy level
  • Youthful feeling
  • Feelings of anxiety
  • Self-Confidence
  • Feelings about the future
  • Impact of the procedure on their career
  • Impact of the procedure on their sex life.

The patients chosen for the study (200 men with male patterned baldness) had their first hair transplant between 1-3 years prior to the study.   Their participation was voluntary and their responses were permitted to be anonymous.

The Results of the Study

We discovered the patients had significant improvements in each of the criteria regardless of their age or their stage of baldness.  In fact, most patients showed a greater sense of well-being in their youthfulness, career, energy level, sex life and overall happiness.  They also felt improvement in their anxiety levels, self-confidence and outlook on their future. These studies confirm the significance of hair to people’s self-esteem

Hair Transplant = A Better Self Image

Natural looking results from today’s advanced hair transplant procedures can help prevent, and in some cases even reverse, many psychological problems associated with hair loss.  The more a person suffers from the effects of hair loss, the greater the positive effect of a transplant on their psychological well-being.

According to the study, patients with an active social life who experienced hair loss at an early age were more likely to suffer from anxiety and other negative effects.  Therefore we can easily assume that hair loss can lead to a negative impact of the future outlook and positive attitude of a person.  These negative feelings seem to reverse after a hair restoration procedure.

Although the response rate was not 100%, the results support the observations of hair restoration physicians and anecdotal evidence from patients. 

Final Thoughts on the Psychology of Hair Restoration

Those experiencing hair loss, but not feeling any negative effects from the loss, are less likely to have a hair transplant procedure.  However, most men and women suffering from hair loss find hair restoration to make a significant improvement in many aspects of their lives.  Whether they’re looking to improve their chances in the job market, seeking a more youthful appearance or simply searching for some greater measure of self-worth, hair restoration is an option that helps broaden both personal and professional horizons.

Since you’re looking at our website, you might already be inclined to have a procedure.  We would be happy to meet with you for a professional consultation appointment.

(1)    Alfonso, Mariola., et al. The psychosocial impact of hair loss among men: A multinational European study. Curr. Med. Res. Opin. 2005; 21:1829-36.

(2)    Mohebi, Parsa and Rassman, William R., Psychology of Hair Transplants, Hair Transplant Forum International, March/April 2008 (Vol. 18, Number 2, Pages 41 and 47), Los Angeles, California.

Is Beard to Scalp Hair Transplant the Future?

Beard to scalp hair transplants have become more common. Most of these are performed to correct male pattern baldness. Encouraged by our strategies and new findings on how to use facial hair, we have performed numerous beard to scalp hair transplants in the last two years with great results. But, the procedure may need to be performed more than once on many of these patients to ensure full coverage of the balding area. Luckily, a beard to scalp hair transplant can provide patients with a plentiful source of hair.  This is especially important for men who don’t have sufficient donor hair due to low density or extensive balding areas that need coverage.

Why has beard to scalp transplant been on the rise?

Beard-to-Scalp-Hair-TransplantOne reason is because our improved understanding of the anatomy of the hair follicular units has furthered the dynamics involved in removing grafts individually. The other reason is that our techniques for extracting follicular units has developed, allowing us to refine the extraction methods from different parts of the body. Previously, extracting hair from the face and implanting it into the scalp was a daunting task that frequently ended with poor results. Now, because of the change in tactics and FUE devices, it is much less demanding to harvest hair from the skin of different parts of the body. Comparing those hairs from different parts of the body like the face, limbs, genitalia, and torso, has taught us that the facial hair is most like the hairs on the scalp. Beard hair has a life cycle, shaft thickness, and length of growth that is very similar to the scalp hair.

Our expanding knowledge of the tools used and the advanced strategies has also made it possible to use facial hair to restore balding regions on the scalp more efficient. In the past, the use of bigger punch sizes made for a bigger wound surface area that prompted healing problems such as, scar development and hypopigmentation of the skin. A deeper insertion of the punches used by older methods led to low-level transections of beard follicles.  Low-level transection resulted in a higher number of ingrown hairs in the donor area of the face. Development of ingrown hairs is an extremely undesirable complication of a beard to scalp hair transplant, which previously restricted the utilization of facial hair for restoration of the balding region. Incision depth control and utilization of smaller punch sizes have lessened such complications, making beard hair an extraordinary source for hair restoration for many men.

Beard hair to scalp transplantation has its own limitations

There are men who can’t grow facial hair or have a very sparse beard. Some men are not allowed to shave or trim their facial hair due to social or religious reasons. Many men would like to keep the option to grow beard in the future.  Extraction of facial hair for these individuals is still a possibility but, the donor area would be limited to the neck and beneath the mandibular line. Despite of the limited donor area in these individuals, extraction of hair from these zones can provide a decent number of suitable hairs that can restore a good portion of the balding area furthering weapons used in the restoration of hair on those suffering from hair loss.

Doctor, Is There Any Hope for Me?

advanced-hair-loss-top-view

A few days ago, I have seen a patient in my office whom I did not recognize. After, reviewing his file, I remembered that he was a patient that we transplanted about a year before. He could not come to see us at his 6 months follow up after his hair transplantation. Now, after a year from the time we performed his hair transplant, he was completely transformed to the point that it was difficult for me to remember him. I reviewed my notes from the first time I met him in our Los Angeles Hair Restoration Center. I had written in his chart his first question when he saw me: “DOCTOR IS THERE ANY HOPE FOR ME?”

He was a man with advanced male patterned baldness (class VII on the Norwood scale) with not the most generous donor hair. His donor hair was very fine. Fortunately his scalp laxity and density could compensate for his fine hair shafts.  We performed a giga-session hair transplant with over 4,000 grafts in one session for him.

Is-there-any-hope-hair-loss-solution

I was extremely pleased to see the transformation in his look and self image. And I was glad to be able to answer his question after one year:

YES, THERE IS HOPE!

Hair Transplant to Prevent Future Hair Loss

Dr. Mohebi,

You classified my hair loss as class III.  I agree with the evaluation but given my family background I will be approaching more towards class V or VI.  My miniaturization % is 30 in both Top and Crown areas which means there is a sign of active hair loss.  Do you think we can arrange something to cover up those two areas as well?  Or, is my miniaturization level too low to have any type of procedure in those areas?

A:

You are class III of hair loss and as you said, you might be going toward class V or VI.  However, prescribed medication might change what is considered your genetic pattern by taking it.  I don’t recommend that we transplant hair in certain areas just in case you get lucky with the hair loss medications, you may never lose that existing hair.  If you progress to lose more hair, you can always have another hair transplant surgery in the future for those existing areas.  Even if you don’t continue hair loss medications, it is hard to predict if you will totally lose hair on the top and crown areas.  Your particular numbers for miniaturization is slightly more than normal.  A good decision today is a good decision tomorrow.

Hair Transplant After Chemotherapy

Hair loss is a common side effect with some types of chemotherapy and can be experienced by both men and women.  Chemotherapy medications attach rapidly to proliferating cells and hair follicles are some of those cells responsible for the continuous growth of the hair.

What do you need know about hair loss after chemotherapy?

Hair loss can typically be seen in the first few weeks after the start of chemotherapy and usually becomes worse with time.  It may be several months after the end of chemotherapy treatments before you notice that your hair growth is getting better.  The new hair may have a different color or texture than you are used to, but it will gain its normal characteristics back over time.

Unfortunately, there is no known medication to completely prevent hair loss after chemotherapy.  It may take months for the hair to get back to normal following the end of chemotherapy treatments. While many patients will experience stabilization or regrowth of hair after completion of chemotherapy, some patients will experience accelerated hair loss that they were to have regardless.

If your hair growth is not back to normal after 2 years from completion of your chemotherapy, you are recommended to be evaluated by a dermatologist or hair specialist for hair loss medical treatments (hair transplantation is possible and eligibility should be determined for you by a quality hair transplant surgeon).

Conspicuous Comb Over Solution with High Density Hair Transplants

Q:

Thank you for your reply to my previous e-mail Dr. Mohebi. I’m getting close to being ready for this, but I still have some concerns that I would like to address prior to booking.

I realize I won’t come out of this looking like Brad Pitt, but can I expect some decent density in the area you’re going to operate on? I’ve seen a lot of pictures of “great” results that were little more than thin whiffs of hair lying limp over shiny, conspicuous scalp. I’d like to be able to style it in the youthful way, showing off my hair line. I suppose that depends on the number of grafts?

A:

The number of transplanted grafts and extent of your balding area are two very important factors in the final thickness of your hair. However, because you have fine hair, even with using the maximum density, you may not achieve the original fullness that you once had. Some patients with the same circumstances as yourself may need more than one surgery to develop maximum density close to that of their original coverage prior to losing hair.