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.