In cases of physiologic gynecomastia where the onset of puberty led to the gynecomastia, the surgical result is typically permanent. Teens that develop gynecomastia through puberty and have surgery should not expect a recurrence unless they gain excessive weight or begin taking medications that are known to have an increased risk of causing gynecomastia (e.g. steroids). Fortunately, we all go through puberty only once in our lives!Now, in addition to correcting the difference between breast sizes, the areola often shrinks when gynecomastia excision is performed. In more pronounced cases, the areola may even be larger. When the glandular tissue is removed, the areola symmetry may improve. As with all cosmetic surgery, results will be more rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation. Now, if you are considering another revision, it would likely be good to seek out another local certified surgeon for a consultation, view some of the available before and after procedure pictures for gynecomastia patients. It is difficult to expect perfection, but best of luck to you!