I had the surgery....
I had pubescent gyno, and I had the surgery, I haven't done any cycles and it seems to be still a bit puffy. Im probably gonna hit a big first cycle this winter, and use good anti-e's, and then get my entire gland removed. They usually don't remove the enitre gland for fear of there being an indention in the nipple area. She removed a pretty large amount of tissue from my right side, and it seems to be flaring up again. I think some are just prone to it, naturally, and there is nothing you can do. Next time I get the surgery done I will have her remove the entire thing. BTW, its all covered under insurance. I didn't have to pay for shit. Its called male gynecomastia, and insurance should cover it all, under any HMO.....
Often times if you smoke alot of pot it will cause gyno, or even different things like cortizone shots for poison ivy. Anything can make it flare up.
p.s. be honest with your doc for the best outcome. Tell them your plans, and what you have done in the past.