Male Pattern Baldness

Affects: Around 7.5 million men in the UK
Most Common Type: Androgenetic Alopecia

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Male pattern baldness, known clinically as androgenetic alopecia, is the most common form of hair loss in men. It affects nearly half of all British men by the age of fifty and is caused by a genetic sensitivity to dihydrotestosterone (DHT), a hormone that progressively miniaturises hair follicles. Understanding the signs, causes, and available treatments helps men make informed decisions about managing their hair health before loss becomes advanced.

Hair loss in men can begin as early as the late teens or early twenties, often starting at the temples or crown before spreading across the scalp. While the condition is biological rather than a reflection of health, the emotional and psychological effects are well documented. Studies link androgenetic alopecia with reduced self-esteem, heightened anxiety, and changes in social confidence. Early intervention consistently produces better clinical outcomes than waiting until loss is extensive.

Research from the British Association of Dermatologists confirms that nearly half of men experience noticeable density changes by the age of fifty. Both medical and surgical treatments exist that can slow progression, stabilise loss, and restore natural-looking density to affected areas.

How Common Is Male Pattern Baldness?

Approximately 7.5 million men in the UK are affected by male pattern baldness to some degree. Globally, androgenetic alopecia is estimated to affect around 50% of men over 50, though onset frequently begins much earlier. Around 25% of men begin to experience noticeable thinning before the age of 21, and by age 35, approximately two-thirds of men have some degree of appreciable hair loss.

The Norwood-Hamilton scale classifies male pattern baldness into seven progressive stages, from minimal recession at the temples through to extensive crown and frontal loss. Understanding where a patient sits on this scale guides the most appropriate treatment pathway.

Early Signs of Hair Loss in Men

Recognising the signs of male pattern baldness early is the most effective way to slow progression. Hair loss rarely announces itself suddenly. Most men notice gradual changes over months or years before the pattern becomes clearly visible.

Common Signs

Receding Hairline

A receding hairline is often the first sign of androgenetic alopecia. It typically begins at the temples, forming an M-shaped recession. The hairline gradually moves backward over time. Men who notice asymmetry at the temples or a widow’s peak forming where one did not previously exist should consider an early clinical assessment.

Thinning at the Crown

Crown thinning appears as a growing bald spot at the top of the scalp. Hair in the crown region contains follicles that are particularly sensitive to DHT. Many men notice crown loss beginning at the same time as, or shortly after, hairline recession starts.

Increased Daily Shedding

Losing between 50 and 100 hairs daily is considered normal. Men with androgenetic alopecia frequently report finding larger volumes of hair on the pillow, in the shower drain, or on a hairbrush. When shedding consistently exceeds these levels without a clear temporary cause, investigation is warranted.

Finer, Weaker Hair Strands

As follicles miniaturise under DHT exposure, the hairs they produce become progressively finer, shorter, and less pigmented. This change in texture often precedes visible bald patches. Hair that once felt thick and resilient may begin to feel fine or limp before significant density reduction is apparent.

Wider Hair Part

A widening parting line indicates that overall density across the scalp is reducing. This is particularly common in men with diffuse-pattern thinning, where loss occurs across the entire top of the scalp rather than at specific points. Comparing photographs taken months apart often makes this change clearer.

Visible Scalp Through Hair

When hair density falls below a certain threshold, the scalp becomes visible beneath the hair, particularly under bright or overhead lighting. This is a mid-stage sign indicating significant follicle miniaturisation has already occurred and that early treatment may have limited the progression if started sooner.

Early Warning Signs

Slower Hair Growth Rate

Miniaturising follicles produce hairs with progressively shorter growth phases. Men who notice that their hair no longer grows as long as it once did, or that styles they previously achieved require less frequent cutting, may be experiencing early follicle miniaturisation.

Reduced Volume and Density

A general reduction in fullness, particularly across the top of the scalp, is an early indicator of androgenetic progression. This may be noticed when styling hair or when friends and family begin to comment on a change in appearance.

Patchy or Uneven Growth Patterns

Areas of the scalp where hair grows in noticeably thinner clusters or where density differs markedly between adjacent zones can indicate follicle miniaturisation beginning in specific regions. This patchiness tends to become more uniform as the condition progresses.

What Causes Hair Loss in Men?

Male hair loss has a range of causes. Androgenetic alopecia accounts for the majority of cases, but other biological and lifestyle factors contribute to hair loss in men of all ages.

Genetic and Hormonal Causes

Dihydrotestosterone (DHT)

DHT is the primary driver of male pattern baldness. It is produced when the enzyme 5-alpha reductase converts testosterone into DHT in the scalp. Follicles with a genetic sensitivity to DHT shrink progressively with each hair cycle, producing finer and shorter hairs until they stop producing hair entirely. Finasteride works by blocking 5-alpha reductase, reducing DHT levels at the follicle and slowing miniaturisation.

Genetic Predisposition

The susceptibility to androgenetic alopecia is inherited from both parents, not exclusively the maternal line as commonly believed. Multiple genes contribute to follicle sensitivity to DHT. A family history of significant hair loss on either side substantially increases an individual’s risk and often predicts the pattern and timing of onset.

Thyroid Hormone Imbalance

Both hypothyroidism and hyperthyroidism can cause diffuse hair thinning by disrupting the metabolic rate of hair-producing cells. Thyroid-related hair loss typically presents as generalised thinning across the scalp rather than the temple or crown pattern of androgenetic alopecia. Treating the underlying thyroid condition usually leads to hair recovery over several months.

Cortisol and Chronic Stress

Elevated cortisol levels from prolonged physical or psychological stress signal follicles to enter a premature resting (telogen) phase. This produces a condition called telogen effluvium, characterised by diffuse shedding rather than patterned loss. Chronic stress sustained over months can lead to persistent hair thinning that overlaps with or accelerates androgenetic progression.

Medical Conditions and Medications

Alopecia Areata

Alopecia areata is an autoimmune condition in which the immune system mistakenly attacks hair follicles, causing sudden patchy hair loss on the scalp or body. It affects men of all ages and does not follow the Norwood pattern of androgenetic alopecia. In some cases it progresses to alopecia totalis (complete scalp loss) or alopecia universalis (total body hair loss).

Scalp Infections

Fungal infections such as tinea capitis (ringworm) create localised bald patches with skin inflammation and scaling. Scientific research confirms that inflammation from fungal infections can permanently damage follicles if untreated. Bacterial scalp infections can similarly disrupt the growth cycle and in severe cases lead to scarring alopecia.

Iron Deficiency

Iron deficiency, including anaemia, results in insufficient oxygen supply to hair follicles. A lack of iron impairs red blood cell production, which is essential for delivering nutrients to the hair matrix. Iron-deficiency hair loss typically presents as diffuse thinning rather than patterned recession, and recovery is expected once iron levels are restored through supplementation or dietary change.

Medications That Cause Hair Loss

Several medication classes are associated with hair loss in men. Beta-blockers used for blood pressure management contribute to hair thinning. Some antidepressants, particularly SSRIs, are linked to telogen effluvium. Chemotherapy drugs cause anagen effluvium by disrupting rapidly dividing cells including those of the hair matrix. Blood thinners such as warfarin, retinoid acne medications, and long-term antifungal drugs have also been associated with temporary hair loss. Medication-related shedding generally reverses after the causative drug is discontinued.

Lifestyle Factors

Nutritional Deficiencies

Deficiencies in iron, vitamin D, zinc, and biotin are each associated with hair thinning in men. Hair follicles require a consistent supply of micronutrients to maintain their growth cycle. Men following restricted diets, experiencing rapid weight loss, or relying on processed food as a primary nutrition source are at increased risk of deficiency-related hair loss.

Smoking

Clinical studies link cigarette smoking with premature androgenetic alopecia. Tobacco smoke constricts blood vessels, reducing blood flow to hair follicles and depriving them of oxygen and nutrients. The toxic compounds in smoke also generate oxidative stress in follicle cells, accelerating miniaturisation in genetically predisposed men.

Tight Hairstyles (Traction Alopecia)

Prolonged tension on hair follicles from tight hairstyles such as man buns, braids, or cornrows causes traction alopecia. The mechanical force damages follicles over time, first causing thinning along the hairline and temples. In early stages the damage is reversible when the cause is removed promptly. Sustained tension over months or years can lead to permanent follicle destruction, at which point hairline transplantation may be the only effective option.

Types of Hair Loss in Men

Not all male hair loss is androgenetic. Understanding the type of hair loss guides both the diagnosis and the treatment approach.

Androgenetic Alopecia (Male Pattern Baldness)

Androgenetic alopecia is the most common type of hair loss in men, caused by genetic sensitivity to DHT. It follows the Norwood-Hamilton scale, beginning at the temples or crown and progressing toward more extensive coverage. It is permanent without medical intervention, and family history on either side significantly increases risk. FUE hair transplantation is the most effective long-term solution for men with stable androgenetic alopecia.

Telogen Effluvium in Men

Telogen effluvium occurs when a significant number of follicles prematurely enter the resting phase, causing diffuse shedding across the scalp rather than a patterned recession. It is triggered by physical stress such as illness, surgery, high fever, rapid weight loss, or prolonged emotional stress. Shedding typically begins two to three months after the triggering event and resolves once the cause is addressed, with full recovery expected within six to twelve months.

Alopecia Areata in Men

Alopecia areata is the most frequent autoimmune scalp condition, causing sudden patchy hair loss in circular or oval areas. It can affect men at any age and does not follow a predictable pattern. In some cases it progresses to alopecia totalis or alopecia universalis. Treatment options include corticosteroid injections, topical immunotherapy, and, in stable cases, consideration of surgical restoration for scarring variants.

Traction Alopecia in Men

Traction alopecia is caused by prolonged mechanical tension from hairstyles such as tight man buns, braids, or dreadlocks. Loss begins along the hairline and temples. Early-stage traction alopecia is reversible if the cause is removed promptly. Long-term sustained tension causes permanent follicle destruction, making this a preventable but potentially irreversible condition if identified too late.

Anagen Effluvium in Men

Anagen effluvium involves rapid, diffuse hair loss during the active growth phase of the hair cycle. It is most commonly caused by chemotherapy or radiation therapy, both of which disrupt rapidly dividing cells including those of the hair matrix. Hair loss occurs within weeks of treatment beginning. In most cases, hair regrows once treatment ends, though texture and density may differ initially during recovery.

Cicatricial (Scarring) Alopecia in Men

Cicatricial alopecia is a group of rare inflammatory conditions that destroy hair follicles and replace them with scar tissue, causing permanent hair loss. Unlike androgenetic alopecia, the affected area cannot regrow hair naturally or respond to standard hair loss medications. Surgical restoration using follicles from unaffected donor zones may be possible once the scarring process has been stable for a defined period, assessed on a case-by-case basis.

Treatments for Hair Loss in Men

Treatment selection depends on the type, pattern, and stage of hair loss, along with the patient’s age, medical history, and goals. Both non-surgical and surgical options are available at Harley Street Hair Transplant Clinics, and many patients benefit from combining both approaches. Comprehensive hair transplant aftercare guidance is provided to all surgical patients.

Non-Surgical Treatments

Finasteride Tablets

Finasteride is an oral medication that inhibits 5-alpha reductase, reducing the conversion of testosterone to DHT. Clinical trials demonstrate that finasteride slows hair loss progression in the majority of men and produces visible regrowth in around two-thirds of users over two years. It is most effective when started early and is taken daily as a long-term medication.

Minoxidil Tablets

Minoxidil is available as a topical solution or foam applied directly to the scalp, and increasingly as an oral tablet. It works by widening blood vessels and extending the growth phase of hair follicles. Topical minoxidil is applied twice daily; oral minoxidil is taken once daily. Results typically become visible after three to six months of consistent use.

Combination Therapy

Using finasteride and minoxidil in combination has been shown to produce superior results compared to either treatment alone. The medications address hair loss through different mechanisms: finasteride reduces DHT and slows miniaturisation, while minoxidil stimulates follicle activity and prolongs the growth phase. A convenient combination spray is also available for patients who prefer a single topical application.

PRP Therapy

Platelet-rich plasma (PRP) therapy involves drawing a small amount of the patient’s blood, concentrating the growth-factor-rich plasma, and injecting it into the scalp. PRP stimulates dormant follicles and improves the local environment around thinning hair. It is used both as a standalone treatment and as a complement to hair transplant surgery to support graft survival and overall scalp health.

Surgical Hair Restoration

Surgery is the most effective long-term solution for men whose hair loss has stabilised and who have sufficient donor hair. Modern techniques deliver natural-looking, permanent results.

FUE Hair Transplant

Follicular Unit Extraction (FUE) is the gold-standard surgical technique for male hair restoration. Individual follicular units are extracted from the donor zone at the back and sides of the scalp and implanted into thinning or bald areas with precision. FUE leaves no linear scar and allows patients to wear shorter hairstyles post-procedure. Graft survival rates above 90% are consistently achieved in professional clinical settings.

DHI Hair Transplant

Direct Hair Implantation (DHI) uses a specialised Choi pen to extract and implant follicles simultaneously, without the need to create recipient sites in advance. DHI offers greater precision in angle and direction control, making it particularly suited to hairline restoration and density work in existing hair. The technique minimises the time follicles spend outside the body, supporting higher graft survival rates.

FUT Hair Transplant

Follicular Unit Transplantation (FUT) involves removing a strip of donor scalp from the back of the head and dissecting it into individual follicular units for implantation. FUT allows a larger number of grafts to be harvested in a single session and is suitable for patients requiring extensive coverage. The procedure leaves a linear scar that is typically concealed by surrounding hair.

Crown Hair Transplant

The crown is one of the most commonly treated areas in male hair restoration. Crown transplants require careful graft planning due to the circular growth pattern of hair in this region. Density expectations and future loss progression must be discussed thoroughly during consultation to ensure a natural long-term result.

View our hair transplant cost guide for transparent pricing across all procedures.

How to Control and Prevent Hair Loss in Men

While genetic hair loss cannot be fully prevented, early intervention and lifestyle adjustments can significantly slow progression and preserve existing density for longer.

Steps to Take Early

Identify the Cause

Visit a professional clinic to determine whether loss is genetic, lifestyle-related, or caused by an underlying medical condition. A dermatologist or trichologist can assess the pattern, perform a scalp examination, and recommend targeted blood tests where appropriate.

Start Medical Treatment Early

Approved medications such as finasteride and minoxidil are most effective when started while follicles are still active and miniaturising rather than fully dormant. Men who delay treatment until loss is extensive have fewer follicles left to protect and respond less well to medication.

Support Nutritional Intake

Ensuring adequate intake of iron, vitamin D, zinc, and biotin provides follicles with the micronutrients they need to maintain healthy growth cycles. A balanced diet with sufficient protein also supports the keratin production required for strong hair shafts.

Manage Stress

Chronic stress elevates cortisol levels and pushes follicles into the resting phase prematurely. Sustainable stress management through regular exercise, consistent sleep, and appropriate psychological support can reduce stress-driven shedding alongside any medical treatment.

Handle Hair Gently

Avoiding tight hairstyles, heat styling, and aggressive brushing reduces mechanical damage to vulnerable follicles. A wide-tooth comb used on damp rather than wet hair minimises breakage at the root.

When to See a Specialist

Men should seek a professional assessment when they notice sudden patchy hair loss, unexplained shedding beyond normal daily levels, scalp inflammation or itching accompanying hair loss, or when hair loss is causing significant psychological distress. Early evaluation improves treatment outcomes and prevents irreversible follicle loss. A GMC-registered surgeon can assess donor suitability, classify the pattern of loss on the Norwood scale, and recommend the most appropriate treatment pathway for each individual.

If hair loss has progressed to a stage where surgical restoration is being considered, an honest assessment of long-term donor supply and future progression is essential to planning a result that remains natural over decades.

Male vs Female Hair Loss: Key Differences

Pattern of Recession

Men lose hair at the temples and crown following the Norwood pattern, forming an M-shape at the hairline before progressing toward the top of the scalp. Women typically experience diffuse thinning across the top of the scalp without a receding hairline, following the Ludwig scale.

Hormonal Triggers

DHT is the primary driver of male hair loss. Female hair loss is more frequently linked to oestrogen fluctuations, postpartum hormonal changes, polycystic ovary syndrome, and menopause, making the hormonal picture more varied and complex.

Age of Onset

Men often begin noticing thinning in their early twenties or even late teens. Women more commonly see changes associated with hormonal transitions later in life, such as post-pregnancy or peri-menopause.

Hereditary Influence

Genetic factors play a stronger and more predictable role in male baldness than in female hair loss. Identifying genetic predisposition early in men allows a more targeted preventive treatment plan.

Frequently Asked Questions

At what age does male pattern baldness typically start?

Around 25% of men begin noticing hair loss before the age of 21. By 35, approximately two-thirds of men have some degree of appreciable thinning. The condition can begin at any age after puberty in those who are genetically predisposed.

Is male pattern baldness permanent?

Yes, androgenetic alopecia is a permanent, progressive condition without treatment. Medical treatments such as finasteride and minoxidil can slow or halt progression and stimulate some regrowth, but they must be continued long-term. Surgical hair transplantation provides permanent restoration of density in treated areas.

Can stress alone cause hair loss in men?

Yes. Significant physical or psychological stress can trigger telogen effluvium, where follicles prematurely enter the resting phase, causing diffuse shedding. This type of hair loss is typically temporary and resolves once the stressor is addressed, though it can accelerate underlying androgenetic alopecia.

Does finasteride work for all types of male hair loss?

Finasteride is specifically effective for androgenetic alopecia caused by DHT sensitivity. It does not treat alopecia areata, telogen effluvium, traction alopecia, or scarring conditions, which have different underlying mechanisms.

How long does it take to see results from hair loss treatment?

Medical treatments such as finasteride and minoxidil typically require three to six months of consistent use before results become visible, and twelve months for full assessment of response. Surgical transplant results are assessed at twelve months post-procedure, by which time the majority of transplanted grafts will have grown through fully.

Am I suitable for a hair transplant?

Suitability for hair transplant surgery depends on the stability of hair loss, the availability of sufficient donor hair, age, and the overall pattern of loss. A thorough consultation with a GMC-registered surgeon is required to assess candidacy. Surgery is generally most appropriate for men whose hair loss has stabilised and who are not experiencing rapid active progression.

What is the difference between FUE and DHI?

FUE involves extracting follicular units individually and implanting them into pre-made recipient sites. DHI uses a specialised Choi pen to extract and implant simultaneously without pre-made sites, offering greater precision in hair angle and direction. Both techniques produce natural-looking, permanent results. The most suitable technique is determined during consultation based on the patient’s specific requirements.

Will hair loss return after a transplant?

Transplanted hair from the permanent donor zone at the back of the scalp is not susceptible to DHT and will not fall out. However, native non-transplanted hair in surrounding areas can continue to thin if medical treatment is not maintained alongside surgery. Combining a transplant with ongoing medication is the most effective long-term strategy.

Patient Testimonials

Aside from achieving fantastic results, we believe that keeping in touch with our patients before, during and after their hair transplantation procedure is paramount – it helps to keep our patients feeling calm and in control. We’re always on hand to provide guidance, support and aftercare advice. Time and again, our patients tell us that this is what sets us apart from other clinics.

You can read our great reviews of FUE hair transplants over on Google.

    
 
 
       Posted on Google  
   
   Anthony Schettino 
 03/09/2026
 
 
 Trustindex verifies that the original source of the review is Google. My experience so far with HSHT Clinics has been excellent. Sara was my first point of contact in the initial consultation. She immediately put me at ease, explained everything in detail and was able to answer all my questions without ambiguity. After that, everything was very well organised and every appointment has been on time and useful. My surgery was performed by Dr Ditta and his team. That was also a great experience (as far as surgery goes). He was very empathetic and took my ideas and opinions into account before proceeding. The recovery was nowhere near as bad as I anticipated - essentially, I was back to normal in two weeks. It’s been 4 months since the surgery and I’ve had a few follow ups with Sara. So far, everything is looking good! Thanks again to the HSHT clinics. Highly recommend at least a consultation with them.
  
 
      Posted on Google  
   
   Nikki 
 19/07/2026
 
 
 Trustindex verifies that the original source of the review is Google. Incredibly friendly staff, wonderful aftercare and meticulous care during the treatment. Couldn't ask for more
  
 
      Posted on Google  
   
   anthony page 
 13/07/2026
 
 
 Trustindex verifies that the original source of the review is Google. Really happy with the service from beginning to end. Aftercare was very thorough. Very pleased with the final results. Final appearance took some time to come through, but the team kept in touch with me throughout and the follow up was very good. Would definitely recommend them.
  
 
      Posted on Google  
   
   Stephen Healy 
 10/07/2026
 
 
 Trustindex verifies that the original source of the review is Google. Had an amazing experience here during my Hair Transplant. Dr Aziz Elgindi was absolutely fantastic from the onset. A very professional surgeon who made me feel relaxed throughout the entire procedure. Could not be more happier with my results. Its only been 6 months and I have a full hairline. I have recommended this surgeon to others.
  
 
      Posted on Google  
   
   Alex Fenn 
 09/07/2026
 
 
 Trustindex verifies that the original source of the review is Google. After years of being insecure about my hairline I decided to finally take the plunge and go for a transplant. I had an initial consultation with Sara at the start of May and she was so informative, happy to answer any questions and there was no pressure to book whatsoever. The flexibility with dates was incredible and we settled on a date at the end of June. I had a series of follow up calls with the surgeon in the lead up too which was so helpful and communication was fantastic. On the day, Dr Elgindi and his team were super welcoming and lovely to be around! The procedure was comfortable and a breeze compared to what I was expecting! In terms of results, I am super happy already with the progress so far, I had minimal swelling and by 10 days all the scabs had fallen off and my new hairline looks fabulous! I am super excited to see the full results by 12 months time, and would recommend this clinic to anyone in a heartbeat.
  
 
      Posted on Google  
   
   Joanna M 
 30/06/2026
 
 
 Trustindex verifies that the original source of the review is Google. Harley Street Hair Transplant Clinic have been great. As a woman, my hairline has always been a sensitive topic for me, to the point I’d use a ridiculous amount of hairspray before going out to cover everything in the event of a slight breeze. I finally started looking for clinics in early 2025 but struggled to find ones in the UK with experience of making a hairline more feminine. Thankfully, an acquaintance recommended Harley Street HTC. After arranging an initial consultation, they were able to provide me with a loss of four and after photos from other women, How many of our clinics were unable to because, understandably, most of their clientele were men. I have also quite a nervous patient to say the least. However, Sara could not have been more helpful throughout the whole process. She answered all of my many questions promptly and with compassion and care. The actual transplant went as smooth as you could hope for, and the clinical team were super kind when I was nervous about them shaving the donor area. For reference I had my temples and my front hairline done in their central London clinic. During the initial two week recovery periods, they went over and above answering my many questions promptly and calming my anxieties around doing different processes correctly. Since then, they’ve checked in on me every three months for the past year, where I’ve met with Sara to discuss regrowth and upkeep. As, unlike most looking to get a hair transplant, I had quite long hair already, I’ll be honest and say that there were some periods where my overall hair did not look great due to the drastically different lengths. However, that could not be helped unless I wanted to shave my whole head and start from scratch. I am happy to report that after 12 months, my donor area is blending in  perfectly with the rest of my hair. Additionally, my recipient area has seen growth of about 4 or 5 inches and is very dense and full. Although I didn’t have the widest area done, I’m still over the moon with my results. Harley Street HTC has been fantastic throughout and I couldn’t recommend them enough!
  
 
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   Fung Shing Hei 
 19/05/2026
 
 
 Trustindex verifies that the original source of the review is Google. Great experience from consultation to aftercare. Dr Ditta’s team were professional, friendly, and made me feel comfortable throughout the whole process. The clinic was clean, well organised, and the support was excellent from start to finish. Would highly recommend.
  
 
      Posted on Google  
   
   Claire Walliker 
 06/05/2026
 
 
 Trustindex verifies that the original source of the review is Google. The practitioner I spoke to gave me some great advice. The conversation was very relaxed and made me feel totally at ease. After for speaking for about 40 minutes, I was given a clear step by step process to follow to get to where I need to be. I would totally recommend anyone who is suffer hair loss a consultation with them.
  
 
      Posted on Google  
   
   Kyle Anderson 
 16/04/2026
 
 
 Trustindex verifies that the original source of the review is Google. I had FUE treatment just under 12 weeks ago and would definitely recommend to others. The treatment was targeted to most of my front hairline and some in the crown. The procedure went smoothly and the team were clear and assuring when talking through the details. The post care instructions were thorough and the communication was kept open for any questions I had. I am happy with my results so far and look forward to further growth.
  
 
      Posted on Google  
   
   Hollie Eagle 
 01/04/2026
 
 
 Trustindex verifies that the original source of the review is Google. Lovely staff and a fantastic service, they make sure everything is explained and that you are comfortable before the procedure. Dr Elgindi did my transplant at the Bury, Manchester clinic, brilliant job, the healing process was fine and went as explained, so I didn't have to feel worried about if it had worked. Grafts are all showing well, just waiting for the shedding, looking forward to seeing the end result and feeling confident it will look good.