Can gyno return even after surgical gland removal?

[Sne212]

I had successful gynecomastia surgery (bi-lateral mastectomy with free nipple graft) and got excellent results 2 years ago.  Curious as to whether gynecomastia can return after that type of surgery (I'm assuming all gland was removed) as I'm considering doing low dosage TRT & GH therapy. I've done TRT/GH previously and even on estrogen blockers found some increased gyno as a result of a few months of low dosage usage.  My original puberty based gyno was extensive not just in the nipple area but with tissue throughout my chest area so curious if those fat cells are still around and can potentially be activated.  Thank you in advance, and thank you for all your great work in this field.    

[Miguel Delgado MD]

It is not very likely but you explain that the the breast tissue was scattered throughout the chest. So, any remaining tissue left can be stimulated. This would be more likely to have enlargement due to increase weight gain and fat accumulation around the chest.