Celebrity Hair Transplant – 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

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

Supply and Demand Mismatch of Hair

I was recently having a conversation with a 31 year old patient of mine who was insisting on having a low and broad hairline. In close evaluation of his hair loss and hair transplant pattern and in particular in microscopic examination of his scalp, I saw that he had significant miniaturization throughout the top and crown area. This is a sign that he is heading towards class VI or VII of hair loss. People with class VI or VII are those who will only have a rim of hair around the scalp.

I had to discuss with my patient that, when I design a hairline, I have to take into consideration the progress of hair loss over time. A good hairline is one that is good now and it will continue to look natural when the person is in his 60s or 70s.

Hair Line Positioning

The reason I am writing this blog is that, Mr. Biden is my example when I have to plan for a higher hairline for younger adults. Many of these younger men hope for a lower hairline. Obviously, I can give them a lower hairline when there is no evidence of advanced hair loss.

When I see microscopic evidence of future higher class of hair loss or when there is a significant family history of high grade baldness, I have to be more conservative. The reason to be more cautious is to avoid the “Joe Biden” phenomenon.

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 Mr. Biden’s hair transplant – Right: Wide area of crown with no coverage – Left: Thin hair on a large area of top

Where are the problems?

  • Poor designing and long term planning
    • The hairline is too low for someone with advanced hair loss
    • The hairline is too broad for the stage of hair loss
  • Lack of sufficient hair to restore the crown
    • There is a large balding area that needs coverage
    • There is not enough donor grafts to cover the crown

By keeping the hairline higher and creating the appearance of some corner recessions, we maintain a natural look. This is also good in the long run, because even if the patient loses the crown with no intention of restoring it, a higher hairline usually goes hand in hand with a balding crown. It does not give an unnatural look.