Hi Alex,
Thanks for your concern and i think we can all see it if we want to see them even without the big arrows.
Yes we do use microscopes (and yes with high enough magnification). And yes i see these small errors unfortunately. These small misses are unfortunately possible with a fue hair transplant and don't make the hairline pluggy at al. If you think they do, then you're just not the right patient for my clinic.
This is one of the reasons why i choose to post high quality photos on my website where you can even use the zoom function and why i always tell my patients to make high quality photos if they post them online. Because if you think as a patient that a doctor can guarantee no multi at al in the hairline, even when using microscopes, it's going to be a hard journey my friend.
Try to get some photos of this HD quality of top surgeons and you will see some cases where multis are missed unfortunately. Don't be surprised. We just don't blur our images on these parts or comb the hair in a way you wouldn't see them.
Anyhow patient satisfaction is the key, and this can only be achieved when you are 100% truthful to your patients. I would even give this patient a free removel of these multis, because it bothers me as a artist. But i know for 100% sure that this doesn't bother him and others that see him in real life. Probably even you wouldn't know that he had a hair transplant if you saw him in real life.
For the hairline we only use single grafts from the nape and from behind the ears that are checked with microscopes.
Hope this answers your concerns. Because as a hair surgeon we reconsider more things then just count the multis in the hairline afterwards. Things like grafts microscopic preparation, grafts survival rate if preperated, transection, telogen hairs, how many singles, how many peaks, etc etc for each case. A hair surgeon considers more things that can lead to a poor or good outcome and in the end a patient just ends up counting multis in the hairline if he isn't informed correctly before the hair transplant. Furthermore it also depends on the design, i.e. it is more difficult to hide every multi behind a single, when making multiple peaks, then is it when you make a straight line without peaks.
Dont get me wrong, this isn't in any case a justification because most of our cases dont even have these little errors. This is just to clarify things on how the hair transplants really are and what you can expect as a patient.