Q: What’s the story with Joe Biden’s hair?

A: Joe Biden — former Senator from Delaware and now the Vice President of the United States — apparently had a hair transplant many years ago using the older hair restoration techniques. This included not only transplanting hair in large plugs (corn rows), but using them to create a broad frontal hairline; a design that generally does not look natural as a person ages.

Also, the older grafts were transplanted in a vertical orientation giving a sprout-like, unnatural appearance.

The use of large plugs and the inefficiencies of the older procedures waste a considerable amount of donor hair, leaving Senator Biden with a dense rim of hair in the front part of his scalp and little coverage behind that.

The repair strategy would consist of removing the larger plugs, microscopically dividing them into smaller grafts (individual follicular units of 1 to 3 hairs each), and then placing the smaller grafts in a more forward direction and in a more natural distribution. This involves using the 1-hair units to soften the frontal hair line and the 2- and 3-hair units to extend the transplant further back on the scalp.

In addition to the hair transplant repair, Biden received significant cosmetic improvement from the natural graying of his hair over the years, as this tends to make the hair appear fuller and any irregularities less noticeable.