Joe Biden Bald Spot
65-year old Joe Biden has been fighting hair loss for many years. In the 1980’s, the Senator elected to undergo hair transplants, which was then a relatively new procedure. At the time, the white-haired senior citizen still had dark hair, making his transplant stand out more than ever. Now, his new position as the next possible vice-president is drawing renewed attention to the experienced politician’s hairline.
Hair loss expert, Dr. Alan Bauman tells Make Me Heal, “I’m not surprised Joe Biden’s ‘infamous’ incomplete hair transplant is getting attention once again, like it did a few decades ago. Many actors, politicians and those in the public eye have undergone medical treatments and sought other methods of restoring their hair—some successfully and others quite obviously not. While the hair transplant methods employed by today’s board-certified hair restoration physicians include training in safe and aesthetic surgery, those who had surgery years ago often were not so lucky. Undetectable restorations using old-style methods are difficult if not impossible, except under the most ideal circumstances. And, while refinements and touch-ups are possible, his results underscore the need for careful long-term planning from the get-go. Thankfully, in the field of microsurgical hair restoration, “we’ve come a long way, baby!” and modern transplants can potentially yield 100% natural, undetectable results.”
Hair restoration has changed considerably in the past decade or so, improving so much that the results are nearly undetectable.
Dr. Bauman reminds Make Me Heal, “Senator Biden’s situation is also an excellent example of the wide misconceptions regarding modern hair transplantation. His transplants, initially performed decades ago, are a “relic” of the dark ages of hair transplant surgery during which time widely spaced, large ‘hair plugs’ (skin grafts) of 20-30 hairs each were used. For perspective, keep in mind that many men who received the first old-style transplants were listening to 8-track tapes and carrying briefcase-sized cell phones at the time. Imagine if George Washington’s wooden dentures were used just a few years ago and how that might contrast with today’s undetectable dental restorations! The point is that we’ve come a long way in the field of the medical treatment of hair loss in just a short period of time, so the past does tend to haunt us a bit.”
Dr. Bauman tells Make Me Heal the differences between the old and newer, superior techniques of hair restoration, “The permanent nature of hair transplantation (which uses hair follicles that are immune to male pattern hair loss) provides a dramatic ‘look’ back into the sometimes ugly past of hair transplantation. In other words, the ‘pluggy’ transplants of years ago are still growing!
These old ‘hair plugs’ are in stark contrast to today’s methods of undetectable single-follicle and “follicular-unit” methods of implantation used in modern hair transplant procedures. In addition, today’s highly trained surgeons are well-educated in the artistic planning of hair transplantation—a very critical step—and use microsurgical techniques to transplant literally thousands of follicles transplanted individually, or just two or three at a time.
The advances in microsurgical techniques also include the planning of the aesthetic parts of the procedure—for example, creating a big ‘wall’ of hair at the hairline, leaving a huge bald spot behind is typically not considered an aesthetic approach.
Today, well-planned and well-executed restoration using follicular-unit micrograft hair transplantation consistently deliver adequate density, coverage and naturalness in an undetectable way. The use of medications or other treatment to protect existing hair is nearly always recommended. The International Society of Hair Restoration Surgery 'ishrs' reports that most patients today reach their hair restoration goals in two sessions or less.”
Dr. Bauman speculates that while the senator has likely had some improvements made to help correct the appearance of the original transplants, the original transplant is still painfully obvious.
“Unfortunately, while it is likely that Sen. Biden has likely had some ‘touch-up’ procedures to soften and refine his hairline using single-follicle grafts, the prior transplant process is still highly visible. Luckily, as he has gone increasingly grey, there’s less of a color-contrast between the hair and scalp, which helps to hide the large old-style grafts, but three main problems still exist…
1) The transplanted hairline shape ignores the loss of the ‘temporal point’ which makes up the all-important sides of the frame of the face.
2) His transplanted hair direction, growing obviously in a nearly vertical or perpendicular orientation to the scalp, is NOT the normal direction of hair growth at the frontal hairline. (This was a challenge of the old-style ‘plug’ transplants which often could not be angulated properly to mimic natural hair growth directions.)
3) Lack of central density—he’s relying on his high-density hairline to provide the frame of the face, instead of the “forelock” area—normally located centrally approximately one inch behind the hairline. More transplants behind the hairline could possibly help him with a more aesthetic hairstyle and eliminate the “backwards comb-over” (and significant hairspray) he’s currently using to provide coverage of the scalp.”
But all is not lost for Biden (pun intended), as Dr. Bauman has some helpful advice to offer for the senator’s future
The naturalness of his transplantation could be improved with some minor ‘hair repair’ work, provided there was enough donor hair in the back of his scalp for additional transplantation. Adjunctive therapies (like finasteride, minoxidil and laser therapy) although usually most helpful in the early stages of hair loss, could now help to enhance and maintain any pre-existing hair at-risk for future loss—thereby enhancing his overall result.
The photo is of a simulated change to his temporal point showing how a slight restoration of that tiny area might improve his overall aesthetic appearance as well as how ‘pluggy’ his results looked in 1987.
Despite his hair’s sad history, it seems to have a brighter future as Joe Biden sets out on the road to the White House.