While I have obviously not examined you, I think it is appropriate to comment on surgery in general and gyne surgery in particular.
Surgery can be life saving and life changing for many people. But surgery itself is a controlled injury --and even with a perfectly performed operation, it is impossible to predict or to control how any one individual will heal after the operation. Many times the problem is corrected but the patient's memory of an injury may linger on and color the entire post operative process. Sometimes there is residual scar tissue or scattered numbness or other very minor problems after the operation. Remember, any injury or surgery heals with scar tissue -- we are as yet unable to make things heal back to the virgin state. So, at best, anticipate that the problem will be better but there will be a small (and probably permanent) price to pay for it. For example, consider the pain of appendicitis and the possibility of real illness ( or even death) if it should burst and remain untreated. Surgical treatment will cure the problem -- but your permanent reminder of the surgery will be some type of scar which will remain for the rest of your life. I will bet that you would always make that trade-off.
In regards to gynecomastia surgery, the main problem is excess tissue on the male chest which does not allow for a trim, taut, muscular appearance. All men, even men with naturally great looking chests, have a small amount of breast tissue present. There is nothing innately bad about that breast tissue. It is when the breast tissue and fat are excessive that the chest contours may become unacceptable. That is when one may consider gyne surgery.
The goal of gyne surgery is to remove the excess tissue -- whether gland or fat alone, or in the vast majority of cases, both gland and fat. The result is often a return to a normal state in which, yes, there may be a small layer of breast tissue beneath the nipple. Gyne surgery is not breast cancer surgery, in which one wishes to remove all the breast tissue. Thus, when I have patients note that they can still feel "something" (and that "something" may be scar tissue or gland or firm fat or any combination) post operatively, I tell them that other people do not walk around and test them by feeling their chest. What is important is that the chest contour be as good as possible -- for that is why the operation was performed.
Gyne surgery, just as any other surgery, can sometimes result in scar tissue, slightly altered sensation of the skin or nipples and other problems -- and some of that may be long standing or even permanent. But in the context of an otherwise well performed operation with a resultant nice chest contour, these problems are minimal and acceptable.
This concept is called "realistic expectations" -- something that plastic surgeons constantly talk about to their patients. Unfortunately, many patients demand and expect a 100% perfect result from their surgery and are unaccepting of a 98% result. It then becomes the duty of the surgeon to explain that a 98% result is very very good. (I think that everyone would be happy with a 98% high school average) Sometimes I have patients with a 98% result and demand revision surgery with the goal of getting 100%. In these cases, I stress to the patient that even in the best of circumstances, there is a certain amount of unpredictability in surgery -- and instead of a 100%, he may end up with a 90%.
This approach is called experience and wisdom -- gleaned from decades of performing surgery and knowing when to revise and when to know that the odds are stacked against you. I find, oftentimes, that younger patients tend to be impatient about their results, have an attitude that everything can be made perfect and that having revision surgery is the only acceptable answer for any problem that they perceive. Sometimes, indeed, revision surgery is indicated -- and sometimes not. It is then that I sit down with them, again, and talk about realistic expectations. The vast majority of patients will come to understand and accept -- and a few will depart unhappy, refusing to accept reality.
Doctors and surgeons adhere to one of our basic tenets: primum non nocere -- first do no harm.
Dr Jacobs