I'm looking for some educated advice...I'm a former HT patient, and I've had 5 recent HT consultations, as I attempt to choose the right surgeon to perform an FU procedure...4 of the 5 surgeons believe they can work with my existing hairline (2 rows--40 plugs)and have a reasonably good end result...however, the 5th surgeon has recommended that the first row of plugs be removed...he feels this will result in the cosmetically best result...obviously, there is more cost plus waiting time to go this route...has anyone had this experience before?...each surgeon is respected in the HT field, although the surgeon recommending the removal may have the best reputation...it all adds up to a tough decision for me...I would appreciate any/all advice...thanks!

I feel the main consideration in determining whether or not to remove the lowest row of plugs is where (how low) the final hairline should be. Remember,if you desire to leave the plugs, the new hairline will be lower than it is now. Will it be cosmetically acceptable and age appropriate twenty years in the future? Also, it will probably take two sessions of fu's to fully block out the appearance of the plugs (this would be especially true if you have coarse, dark hair).
If the hairline is or will be too low by leaving the plugs, REMOVE THEM !!!! The cost of doing so will be the best money you have ever spent.

I also have some old plugs in my hairline. These have thinned somewhat and were high enough that I got away with surrounding them with new FUs and only had to lower the hairline about 1/2 cm or so. However, mine was an unusual case, and I think normally it would require lowering the hairline 1 cm or so with FUs to effectively obscure the plugs. As we all know (or should by now), a natural-looking and age-appropriate hairline is critical to a sucessful HT result. I strongly suspect in your case you will be much happier in the long run if you remove them.