I'm wondering if it’s possible for the breasts to grow back after surgery.

Answer: It is possible for breast tissue to grow back after surgery for gynecomastia.

Gynecomastia occurs in men from an accumulation or overgrowth of glandular breast tissue and/or fat. When the excess tissue is glandular, it usually has developed because of stimulation from endogenous (internal) or exogenous (external) hormone exposure, or from hormone mimicking prescription or illicit drugs, i.e. marijuana. The treatment of gynecomastia includes identifying and discontinuing any causative agents and then surgery only if there is no spontaneous resolution. If the stimulus remains after surgery, the glandular overgrowth and associated symptoms may recur. This is due to the fact that a small amount of the glandular tissue is usually left behind on the undersurface of the nipple areolar complex (NAC). This tissue is attached to and continuous with the skin of the NAC. If it is thinned excessively during surgery then the circulation of the NAC may be compromised, resulting in necrosis and possible loss of part or all of the NAC. Also, and more commonly, the consequence may be contraction and or adhesions from scarring that may distort the appearance of the NAC.

When the excess breast tissue in gynecomastia is in part or completely fatty in nature, the risk of recurrence is less than with glandular tissue. In this case the standard treatment is with liposuction, and recurrence risk would be more or less the same as with liposuction in any other area of the body. Re-accumulation of fatty tissue may occur with subsequent weight gain after liposuction. Areas previously treated with liposuction, however are usually more resistant to this re-accumulation than other untreated areas of the body.