Can gynecomastia return after surgery if I still continue to have low testosterone levels in the body?

Thank you for sharing your excellent question.  If all of the male breast tissue was removed during your surgery you will not have a recurrence despite low testosterone levels.  Hope this helps.

Assuming that all of the glandular tissue was removed, the chances of your gynecomastia returning are extremely low to non-existent. Hope this helps. 

With proper treatment of gynecomastia, which includes removal of all the tissue present, it is unlikely to recur. No matter what the circumstances, if the tissue that reacts to medication or hormones is no longer present nothing will happen. If you remove the engine in your car and keep filling the tank with gas nothing will happen when you turn the key.
The most common artificial cause of gynecomastia recurrence is incomplete removal of the tissue. You can wait for a long time for the "swelling to go down" but you will find excessive fullness from the tissue that has not been removed. This is not uncommon. Treatment would be a more thorough removal of the tissue as a secondary procedure.