The return of glandular tissue is very rare, but it is possible to have glandular tissue recurrence after gynecomastia surgery. This is because gynecomastia surgery does not seek to eliminate 100% of the glandular tissue. The reason is that a depression around the nipple would be caused if the surgeon tried to remove all the gland tissue, because unlike the surrounding skin, the nipple area does not have much fat underneath it. Rather, it is the glandular tissue that keeps it at or above the level of the surrounding skin. During gynecomastia surgery, we seek to create a natural appearance, therefore leaving a bit of cushion to the nipple is needed.
Can this tissue grow back? It is extremely unlikely. Unless the person is using steroids or has a medical problem, this tissue lies dormant. The most likely cause for recurrence of gynecomastia is either incomplete removal the first time or significant weight gain by the patient over the years. The most common patients that seek gynecomastia revision have had liposuction to the chest, but once in a while we see a patient that has had excision, a number of years back, with recurrence.