The punch-outs would be re-used and placed into areas of weaker density, but even if you go down the HLC repair route, you're going to be using a) probably 200-400 singles hairs and softer doubles to recreate a new hairline and b) you're still going to have weaker areas that need to be addressed behind the hairline at some point in time (which HLC will probably do for you, to be fair). To me it looks poor but I'm not a HT laymen so I'm casting a more critical eye than the man on the street. Also different lighting will exaggerate or mask the issues. Personally I would not be happy with this outcome and I'd want to get the pluggy grafts removed and irregularities added for a more natural result without lowering the hairline further. But I understand that this comes with an unanticipated cost (I'm in a similar boat!). What it's worth bearing in mind is that the HLC repair is not guaranteed to be a success. If you end up not happy with the repair then you've compounded the problem even further by having the hairline lowered. A good example of this is @Tommy1991. He had bad work initially, went to a reputable clinic for a fix, didn't get fixed and essentially just ended up with more grafts to be extracted later, and is now undergoing a total hairline removal at much bigger costs, time, hassle and worry than the initial work. These things can dominate a person's life for quite a while until they are resolved for good, so I understand how conflicted you probably feel right now. Personally I don't think you need to go down the Tommy/Feriduni full hairline removal and start over approach. But equally I'm not massively convinced that bringing down your hairline another half cm with HLC is ideal either. The Hattingen 'partial removal'/create some softer breakup option that RTC underwent might be a nice middle of the road option that wouldn't cost the earth. At the very least, speak with Dr Sever and get his thoughts.

Part of me does just want to let the people who I’ve always paid £8K to make good on their initial promise. A natural hairline.    but I agree. At this stage, it is more complicated then just adding singles at the front and a slight softening of the temple angle 

Thanks for your response.   I think the thing I find tricky here is the idea of removing healthy multiple grafts would obviously thin it out a bit, and particularly on the left side the density is already poor. There are very few lightings in which it doesn’t look very sparse.    The other issue is £££. I don’t have much of a budget for it, so if I don’t go back to HLC, I may have to wait years before I can justify another essentially optional cosmetic procedure, such as a hair transplant. HLC have guaranteed that there will be no cost if I go back.   However, the thing that does unnerve me is that they have refused to left me speak to a doctor and maintained that the only repeat ONLY way that they can gage what needs to be done, is with me sat in the hot seat with them in Ankara. Seems an awful expense in both time and money (getting there) to just be told that they can quite easily add a few singles in the front. Especially when the line is already so bold and unnatural looking.    What do you think of the result so far? A glaringly unnatural result, or something that looks fine if you don’t look to closely at the line itself? 

No-one commented on these points you made but I thought I should add some context for anyone considering going to another Country for a hair transplant. Put simply: The culture shock is real, and no-one ever talks about it. Because no-one ever talks about it, it catches you off guard. To be clear, this is NOT the clinics fault, it’s just the way things are done in a different culture. I think people should talk about this more because it will set expectations for others who go. Here are a few of my culture shock moments - As you mentioned, the driving in India is much different than America. Drivers would be arrested if they drove in the USA like they drive in Delhi. To be honest, I started to like it - it was like being on a roller coaster. Kind of fun! - The Delhi airport staff (especially immigrations) does not care about you. They will talk with their friends and laugh and have a good time instead of helping while you stand there. Finally they will get around to helping you, but not without stopping half a dozen times to talk more with their friends and laugh some more while they’re helping you. I learned on the India reddit forum that this is common and just the way it is.  - Like you, my hotel driver also spoke no English. I think a 5 star hotel that has international customers should have drivers that speak some other languages so as to put their customers at ease. But that’s just my opinion.  - This last point is not a criticism of Eugenix, but rather just a difference in culture I think. In the USA, if you go for a surgery, you are guided through the process from the moment you walk in the door and made to feel comfortable before they ever leave you alone. For example, in the USA, when you are taken from the reception area on the first day, a nurse or patient-care tech will greet you in reception with a smile on their face, and they will explain everything that is going to happen. For example, they would say; “Welcome to Dr. X’s office! We are so happy that you are joining us today. Before I take you over to the operating center, I want to give you a quick rundown of everything that will be happening today. First, we will bring you to a pre-operating room so we can take your vitals and get a few pictures taken. Then the doctor will speak with you and draw your new hair line. With your permission of the new hair line, we will then shave your hair and wash it. Finally, we will bring you to the operating room.” That is what Americans are used to and it puts your mind at ease. This person who informs you of everything becomes your friend, or point of contact, for your time there. In India, it’s a bit different. After sitting in reception, someone who doesn’t know English (a tech) comes to reception and motions for you to follow them. No words are spoken, so you are a bit confused what is happening. But then you follow him to a room, and they tell you to sit down, and then they close the door. So then you’re just sitting in that room for 10 or 15 minutes wondering what is going on. This is a bit nerve wracking when you’re in a different culture. Then a nurse comes in and tells you she is going to do some tests, etc, and it all unfolds. It’s just a very different process, but if you know it’s going to happen beforehand, then you will be comfortable with it. Now that I know the process, I will be fine with it when I go back for a second transplant (if needed). But it is definitely a bit of a culture shock which is why it’s a good reason to talk about it so others know what to expect.  

This is really something that I think needs to be discussed with Dr Pitella probably just before and during the surgery because being a NW 7 with only a small amount of scalp donor and using lots of beard donor, you really don't know how dense you're going to be able to get even if you used up as much grafts as possible. You may have to decide at the time you're going through the process because some of this is going to depend on whether he will be able to get either more or less grafts than he estimated and if you need either more or less than he estimated. I'd let him be aware that you'd rather be more full in the frontal half and are willing to leave the crown low density if he can't get enough to give full coverage everywhere or if he reaches a certain amount of grafts due to your budget or because you want to save some for later or don't want to be depleted. With that said, at 52 and a NW 7 I'm guessing you'd be thrilled to have a rather full front half even if you're still very thin in the crown. Be aware though that hair greed hits a lot of us and you'll probably eventually be wanting to go back for another session to try to get enough grafts to fill in the crown anyway, so keep that in mind.