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.

The Evolution of ARTAS

Many people are unsure about the role that robotics will play in the future of hair transplant procedures. Dr. Mohebi recently had a chance to discuss this fascinating topic with Spencer Kobren, the host of “The Bald Truth.” They discussed the evolution of the ARTAS robotic hair transplant system as well as Dr. Mohebi’s work with ARTAS. Dr. Mohebi shared his insights into the future of robotic FUE (r-FUE).

Catching Up With Our Hair Transplant Contest Winner

After Hair Transplant

As we approach the end of 2015, I thought it would be a good time to check in with the winner of our hair transplant contest.

Marc Richter was the lucky winner of our first ever hair transplant contest back in January. Like many people in Los Angeles, Marc moved here to chase his artistic dreams. He also saw California as a way to escape his former life filled with insecurities and bullying.

Marc moved to Los Angeles in his 20s and that is also when his started losing his hair. His hair loss had progressed to the point that he was having trouble hiding the loss on top of his head. While he was able to successfully start a music career on his own, he was not in a position to fight his hair loss on his own. After creating an entertaining video that caught the attention of our judges, Marc was chosen as the winner of the contest. It’s been about 9 months so we decided to check in with Marc and see how the transplant has changed his life.  Here’s what he had to say:

“Receiving the surgery has affected my life for the better mainly thanks to a new found confidence in myself. I look in the mirror and, although I don’t see the fullest head of hair, I don’t see the worst like I used to. We’re almost 9 months after the surgery and with every new haircut, I see progress! It’s an incredible feeling to think you’re getting younger when you are in the years where you have to come to terms that you’re aging. I also recently have been on a dating spree and I’m happy for the extra hair because it’s restored my confidence when talking to random women. It’s also helped with talking to people in general. In this town, people are critical about the looks of others and I’m grateful beyond words that I’ve been given this second chance to fit in.”

A story like Marc’s makes me thankful to be in a position to make a real difference in the lives of so many people. Undergoing a hair transplant is not just about hair restoration. It is also about rediscovering confidence and a new sense of pride in the appearance of the patient.

Keep watching our blog for more information about our next contest. Even though 2015 is almost over, 2016 promises to hold great advances in the field of hair transplantation.

The Basics Behind Biden’s Balding

Months of speculation ended in October of this year as Joe Biden announced he will not run for president in 2016. Biden’s decision to not run ends the question of whether the Democrats would support him or Hillary Clinton next year.

However, there is one Joe Biden question that has not been answered:

What is wrong with his hair transplant???

Supply and Demand Mismatch of Hair

Some time ago, I wrote an article about Joe Biden’s hair transplant and why it was not very well executed. The article was inspired by a conversation with a patient in his 30s who insisted on having a very low and juvenile hairline. As always, I performed a close evaluation of his hair loss, his family history of hair loss pattern and also did a microscopic examination of his scalp and hair. The results showed a significant miniaturization throughout his top and crown area. This was a warning sign that he was on his way to class VI or VII hair loss that would result in nothing more than a rim of hair around the scalp. This was also confirmed by his family history. I explained to the patient that designing a hairline needs to take into account the progress of hair loss over a period of time.

“The Biden Phenomenon”

Mr. Biden is a good example of needing to plan for a higher hairline in younger adults. Many younger patients hope for a lower hairline. The lower hairline is possible when there is not much evidence of advanced hair loss. A significant family history of high-grade baldness requires a more conservative approach in order to avoid donor/recipient mismatch OR “Joe Biden phenomenon”.

Here is a good example of the problems with Mr. Biden’s hair transplant. The photo above shows thin hair on a large area on the top of his head despite having almost a juvenile hairline.

A List of Biden’s Hair Transplant Troubles

Vice President Biden’s hair transplant troubles are numerous and have not changed much over the years. They still include:

  • Poor initial designing as well as poorly executed long term planning
  • His hairline is too low on the head for someone with advanced hair loss
  • His hairline is way too broad for the stage of hair loss he is currently in
  • There is a lack of sufficient donor hair to restore the crown
  • He has a large balding area that really needs coverage
  • Biden does not have nearly enough donor grafts to cover the crown

To put it simply, keeping the hairline higher and executing the appearance of a corner recession helps to create and keep a natural look on a patient. This is especially helpful for patients that lose their crown and have no great desire to restore it. A higher hairline works naturally with a balding crown and doesn’t give the patient an unnatural look

Joe Biden phenomenon should be avoided if possible.  However, we can help patients who already have this condition.

FUE to Create a Balance

One way to help is to use FUE method to extract more hair from the donor area. The hair could be used to restore the balding patch on the crown while reducing the density of donor hair to help create a more balanced look.

Beard to Scalp Hair Transplant

We have successfully utilized Facial to Scalp Hair Transplant (FSHT) in the last few years for people who are in a high stage of hair loss.  This source of hair that has been available to us only in the last few years thanks to the new techniques of FUE transplant could fill the areas that don’t have adequate density or even restore the areas that are completely bald.  Having beard to scalp hair transplant technology available has allowed me to be a little bit more aggressive with my hairlines and to bring them lower when needed if the patient is open to using his beard hair in the future.

Head Trauma after Hair Transplant – Have I Lost My New Hair?

Q:

Hi Dr. Mohebi,

After hair transplant head traumaI hope you are doing well. I have a question that might not be a huge concern but it is bothering me so I need to ask it.

It’s been about 3 weeks since my FUE hair transplant procedure and everything is “so far so good”. Well, it all seemed okay until earlier today.

About 2 hours ago, I accidentally bumped my head on a shelf. I hit my head directly on the area where the grafts were placed during the surgery. I’m not bleeding but the wounded area is red.  My level of worry might be worse than the actual level of redness on my scalp at the moment.

Do I need to be concerned about this having a negative impact on the health/growth of the newly transplanted grafts?

Thank you for any advice you can give me.

Regards,

A:

Thank you for writing and for taking the time to ask me about your hair grafts. My medical staff and I are always open to answering questions patients have after their surgery.

In general, the newly transplanted hair grafts are normally taken three weeks after a hair transplant is performed. At this point, the hair shafts on them have either fallen off or they will soon fall off.

By this point of the recovery process, your transplanted hair is expected to behave like normal native hair that is already present on the scalp. While I am sorry that you bumped you head on a shelf, any day to day trauma and/or injuries to the scalp have to be classified as being quite severe in order to damage a normal hair.  Most likely, your transplanted hair grafts are going to be fine and you did not lose anything during the incident.  You can stop worrying about any lasting damage to your grafts.

MA

More than The Length of a Hair’s Difference

More than a lengthWhile hairline reduction and hair transplants can both lower the hairline, there are quite a few differences in the procedures. How does a patient decide which procedure is best for them? The decision eventually comes down to a variety of factors:

  • A consultation with a good hair transplant doctor
  • The expectations the patient has before undergoing a procedure
  • Which of the two procedures best fits their expectations and their individual needs

When a patient is considering having a procedure to lower his or her hairline, it’s important to know the different advantages of the two procedures:

Hairline Reduction Advantages:

The first advantage of a hairline reduction is the fact that it is a quick procedure.
A hairline reduction procedure can also create a high density hairline which might be desirable by many patients.

Advantages of a Hair Transplant to Lower a Hairline:

One advantage of doing a hair transplant to lower the hairline is that the final result is more natural looking. A good hair transplant surgeon can create a very natural looking hairline that reflects the normal transition of hair density.

A hair transplant procedure avoids the linear scar that a hairline lowering procedure creates. Instead of a scar, the patient can expect a natural looking transitional zone in their hairline with a hair transplant. A hair transplant to lower the hairline also allows for more flexibility with the placement of the hair/overall hair direction and the curvature in which the surgeon can mimic a perfectly natural hairline.

What Is The Next Step?

The next step for a patient is to study the advantages of the options listed above to determine which of the options best fits their needs. Once the patient has determined which technique is best for them, they should find and consult with a good doctor to determine if they are a viable candidate for either a hairline reduction or a hair transplant to lower the hairline.

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.

Lessening Social Anxiety about Your Transplant

Q:

hair transplant anxietyThere’s one area of my life that is more pronounced than my hair loss. It’s the amount of anxiety I suffer from on a daily basis. My anxiety levels increase greatly when I find myself in social situations surrounded by people chatting constantly. It’s very overwhelming to me trying to keep up with the various conversations.  I’m working towards getting a transplant but my anxiety about answering questions about the procedure is already growing.  Do you have any advice for my situation?

A:

We conducted a study whose results were published as Psychology of Hair Transplant in Hair Transplant Forum Journal in 2008.  In this study, we noted that younger men with hair loss had a significant improvement in their anxiety after restoring their hair.  This improvement could be explained by the social anxiety these men endured on a regular basis due to their hair loss.

So you might in fact improve your anxiety by doing a hair transplant procedure and by taking care of your male patterned baldness.

One important fact to remember is the transplanted hair grows very slowly.  This means that people who see you on a regular basis won’t be able to detect the new hair growth.  It will not be difficult to hide the new hair except for the first few days/weeks.  During that time period, you might see some redness or scabbing from the newly transplanted hair in the recipient area.