Gyno came back twice even after surgery

[Triever]

Good Morning,

Back story:
In 2014 (age 23 now 30) and I took pro hormones back when you could purchase online. Did 3 cycles as well as PCT (Post cycle therapy) which didn't work and I took Letrozole and Tamoxifen to combat the gyno that came directly after the cycles (yes I know not that smartest decision to take Letro or do more than 1 cycle after seeing gyno). Ever since gyno has been an issue and never was until I took Pro Hormones.

Currently:
I've had surgery both left and right nipple about 3 years ago when I was in the Navy and since then its come back twice now. The first time it came back after surgery I went to the Doc straight away and they gave me a hormonal panel (all tests normal) and put me on tamoxifen for a month and it subsided and stopped. The 2nd time happened during the pandemic and I couldn't be seen as easily so I wasn't seen until months later. When I was seen I got another hormonal panel which came out normal again and before they put me through another surgery they want to put me on tamoxifen twice a week tues and thurs for 90 days to see how that works. They also keep telling me marijuana could be the issue but I rarely smoke and I never did in the military.

I went to a plastic surgeon and he told me that the surgeons who did my surgery did it wrong and you need to remove all the fatty tissue caused by gyno, is this correct and there was a possible mistake with the first one?

I have friend who cycled around the same time as me and hes going through the exact same issues of gyno returning who is now prescribed Tamoxifen everyday, and I've also seen something similar on this forum from this individual https://www.gynecomastia.org/forum/ask-a-doctor/38/gyno-but-with-normal-hormone-levels/33046/msg209942#msg209942 .

At this point I have no idea how to completely stop this from happening. Could it be something similar to say supplements taken by a trans-man/woman that are irreversible? I still workout 5 days a week and eat healthy meal preps and only drink on weekends. I notice when I drink the effects of gyno is more noticeable so I don't drink as often as I used to. Letro was the only thing to reverse the effects but the moods swings and damage to my body from it was not worth it.

If anyone can help me from my past stupid mistakes I've made id be very grateful and could provide pics if needed.

Thank you,

Triever

[Dr. Cruise]

HI Triever,

Thank you for posting and providing a detailed account of your situation. As in most cases, a photo will be really helpful to see. 
it is very rare for the gyne to grow back. I have performed thousands of cases and this just isn't something normally seen. When patients seek out my help after having gyne surgery elsewhere, almost always it is a matter of residual tissue still being present. At times, there can be a component of scar tissue that is a contributing factor. 

I would definitely recommend posting a photo here for us to review and provide more insight. 

Thanks, Dr. Cruise