How can I fix a pluggy hair transplant? (Photo)

For sure it can be fixed.Just my personal view as a hair transplant surgeon,unnnatural look is NOT only because of multiple hairs in frontal hairline zone but also not an artistic shape of hairline design applied such as man hairline should have had ''inverted V'' pattern at frontotemporal corners,midfrontal point should be lower than fronto-temporol point in vertical dimension,and there is no accordance with hairline and temporal triangle(peak).and your hariline seems flat (should have been a bit trianguler shape)...SMP does not seem to be capable to fix all these ,revision hair transplant would work very well ..I hope it helps.

Hello, Dr. George Abrahamian MD here, La FUE Hair Clinic in Pasadena, CA.
Hairline structure is extremely important to the final appearance of a hair transplant. The design of the hairline should be suitable for you at your current age, but also should be suitable for you as your face matures over the subsequent years of life. The grafts on the hairline itself should be single haired follicles to give it a soft and natural appearance. If double and triple haired grafts are implanted along the hairline, it can give an unnatural and hair-plug like appearance.
You do have a few options, though. I highly recommend against SMP in the area as it currently stands, it will make it look even more natural. If you have the patience to do so, you can pluck the multiple hair follicles on the hairline to only have 1 hair showing per follicle, but that would be something you will likely need to do frequently and likely for the rest of your life, and would be quite time consuming. Another option would be to have electrolysis done on the front few rows of grafts, which will raise your hairline, and set the stage for a second transplant to repair the design of the first transplant. This option, however, will cause you to lose a medically significant number of hair follicles that were previously grafted. The 3rd option would be to micro-punch out the existing front row of hair, and implant those hairs somewhere else, and then down the line have a 3rd transplant to create a more natural appearing hairline. This option will leave you with FUE micro-punch scarring across the hairline, which is not ideal either. The fourth option would be a repair transplant, to reconfigure the hairline with single haired follicles, and add some density between the grafted follicles you currently have. This will lower your hairline a few millimeters, but should soften its appearance. This option will lower the hairline, which may not be ideal, as the location of the hairline is just as important as its structure/design, and the follicular density of the grafts on the hairline. In my opinion, option 4 is the easiest option if your donor provides the necessary number of grafts, and if you're agreeable to a very slight lowering of the hairline (likely 2-3 millimeters).
I hope this helps, and best of luck on your hair restoration journey!