In short
- Overall satisfaction with this surgery is high and has been measured. In a prospective study with 611 patients, satisfaction with the breast and psychosocial and sexual well-being improved significantly at 6 weeks and at 6 months, with very large effect sizes.
- ⚠️ And there is a finding from the same study that almost nobody publishes: PHYSICAL well-being was still below the pre-operative level both at 6 weeks and at 6 months.
- 🔑 That is the explanation for the slump: you like how you look before you feel physically well. The two curves do not move together, and nobody warns you.
- The lowest point is usually in the first two weeks, when the breasts are high, firm and swollen and do not look like yours.
- That appearance is not the result. Implants descend and soften over the following weeks.
- ⚠️ A result is not judged before six months.
- Older patients scored significantly lower on satisfaction with the breast and with the surgical experience, in that same study.
- 🔑 And a underlying honesty: decisional regret has barely been measured in this surgery. There is a great deal of literature on satisfaction and very little on regret proper.
Cosmetic surgery websites publish testimonials and “after” photographs. Almost none of them mentions that there is a phase, between the first week and the first month, in which a lot of people ask themselves what they have done.
This page describes that phase, explains why it happens, gives the figures for what has been measured — including a fairly uncomfortable one — and says what to do when what does not convince you is the result and not the moment.
The slump: what it is and why it happens
What gets described
Between the first few days and two or three weeks, it is very common to feel some combination of this:
- “They are not mine.” The breast looks and feels like a foreign body, because it literally is one and has not yet integrated.
- “They are sky-high and rock hard.” That is to be expected: the implant starts above its final position.
- “I have overdone it” or “I have gone too small.” With the swelling, there is no way of knowing.
- Disproportionate tiredness for what you have done.
- Irritability, easy tears or low mood with no clear reason.
It is not unusual. It does not mean you made a mistake. And it does not last.
🔑 Why it happens: the two curves that do not move together
Here is the explanation, and it comes from a measured finding almost no website publishes.
A prospective study assessed 611 patients having submuscular augmentation with the BREAST-Q — a validated questionnaire — before surgery, at 6 weeks and at 6 months. What it found:
| Dimension | Outcome |
|---|---|
| Satisfaction with the breast | Significant improvement, with an effect size of 3.66 at 6 months |
| Psychosocial well-being | Significant improvement, effect size 2.39 |
| Sexual well-being | Significant improvement, effect size 2.56 |
| ⚠️ Physical well-being | Still significantly below the previous level at 6 weeks and at 6 months |
Those effect sizes are enormous on the scale used: satisfaction with the result rises a great deal and rises early.
🔑 And at the same time, the body takes longer. The authors themselves conclude that doctors should tell patients that submuscular augmentation is associated with delayed recovery of physical functioning.
Translated into experience: it is perfectly possible to be pleased with how you look and to feel physically worse than before surgery, for months. It is not contradictory. It is what the data show.
And one more thing from that study
Satisfaction with the breast and with the surgical experience was significantly lower in older patients. The authors recommend bearing it in mind when giving information.
⚠️ It does not mean that beyond a certain age it is not worth it: it means expectations need setting more carefully. It is set out in the page on age.
What is NOT regret
It deserves separating, because it gets confused all the time:
High, firm breasts. They come down. It is the number one complaint of the first month and the one that contains the least information about the final result.
Asymmetric swelling. The two sides go down at different rates. ⚠️ What does need reporting is asymmetry that grows within hours with pain: it is in the warning signs page.
Feeling you have gone too big in week two. With swelling, volume cannot be judged.
The tiredness. It is what the physical well-being score in the earlier study measures, and it takes time.
🔑 Practical rule: nothing you think about the result in the first few weeks is reliable information about the result.
When it is worth speaking up
From six months onwards, once the swelling has settled and the tissues have bedded in, what you see is the result.
If at that point there is something that does not convince you, that is the moment to say so at an appointment, not to keep quiet. And two things are worth separating:
🔑 But talking is not operating, and there the timescale at this practice is different: for elective revision surgery we wait a year. Six months is enough to see the result; the year adds the second thing needed, which is time to adapt to it. Many things that seem intolerable at six months stop being so at twelve without anyone having operated on anything.
What is correctable with surgery
- The volume, if it is not right. It is a new elective operation, with its own risks.
- Malposition of the implant.
- Capsular contracture, in grades III and IV.
- Significant residual asymmetry.
- Rippling or a visible edge, improvable by increasing the cover — with fat, for example, as in hybrid augmentation.
⚠️ With two warnings to keep in view: a reoperation has its own risks, and the FDA is explicit that there is no guarantee of a satisfactory aesthetic result from any reoperation.
What is not corrected by operating again
When what was expected of the surgery was not something surgery could give.
If the distress that led to surgery was not in the breast, it is still there afterwards — and a second operation is not going to resolve it either. It is the situation in which operating again does someone no favours.
⚠️ This is not a judgement. It is why the prior assessment matters so much, and it is in the page on who is a candidate.
And an honest word about the data
Regret as such has barely been measured in this surgery.
There is a great deal of literature on satisfaction — how much the patient likes the result — and very little on decisional regret, which is a different thing: whether, knowing what they know now, they would do it again.
🔑 They are different questions and they get different answers. Someone can be satisfied with their breast and at the same time think the process was not worth it. That this figure barely exists is, in itself, information.
What we do know, and it is measured, is what is above: satisfaction with the result rises a great deal and early, and physical well-being takes longer than people are told.
How the likelihood of regret is reduced
There are no guarantees, and there are things known to help:
- That the indication is the right one. An implant on a sagging breast does not lift it, and that is the number one source of results that do not convince.
- That the volume is matched to the tissue, and not the other way round. It is in the guide to choosing the size.
- That expectations are discussed beforehand, including the ones surgery cannot meet.
- That you know about the physical well-being finding, which is exactly what this page exists to tell you.
- That the decision is yours, and not a date’s, a partner’s or an offer’s.
- And that there is no rush. There is no compulsory cooling-off period in Spanish law — and there is a right to withdraw consent in writing at any time, explained in the paperwork page.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
I have just had surgery and I regret it. Is that normal?
It is common in the first few weeks and it is almost never information about the result. In that period the breasts are high, firm and swollen, and the body is worse off than before surgery. A prospective study of 611 patients found that physical well-being was still below the previous level even at 6 months, while satisfaction with the breast had already risen a great deal.
When can I judge the result?
From six months onwards, once the swelling has settled and the tissues have bedded in. Before that you are judging swelling.
I think I chose the wrong size.
In the first few weeks there is no way of knowing. From six months onwards, if that is still your impression, it is a conversation for an appointment. Operating is another matter: for elective revision surgery we wait a year here, because as well as the final result you need time to adapt to it. Changing the volume is possible and it is a new operation, with its own risks.
Is it normal to be pleased with how I look and feel physically unwell?
Yes, and it is measured. In that same study, satisfaction with the breast and psychosocial and sexual well-being improved with very large effect sizes at 6 months, while physical well-being was still below baseline. The two curves do not move together.
How many people regret a breast augmentation?
There is no good figure, and it is worth saying so. There is a great deal of literature on satisfaction and very little on decisional regret, which is a different question. What is measured is that satisfaction with the result is high.
Can it be undone?
Implants can be removed. It is worth knowing how the breast looks afterwards, because it does not go back to the starting point: it is explained on the page about replacement and removal.
And if what does not convince me is how I feel, not how I look?
Then a second operation is probably not the answer, and saying so is not neglecting anyone: it is the opposite. It deserves a calm conversation before anything else is considered.
Sources
- Alderman AK, et al. Understanding the effect of breast augmentation on quality of life: prospective analysis using the BREAST-Q. Plastic and Reconstructive Surgery, 2014. PMID 24675184. — 611 bilateral submuscular augmentation patients who completed the BREAST-Q before surgery and at 6 weeks and 6 months: mean age 33.5, mean body mass index 21.7, mean implant volume 360 cc, 73% with a silicone implant; significant improvements in satisfaction with the breast, psychosocial well-being and sexual well-being at 6 weeks and at 6 months, with Kazis effect sizes of 3.66, 2.39 and 2.56 respectively at 6 months; physical well-being remained significantly below pre-operative scores both at 6 weeks and at 6 months; satisfaction with the breast and with the overall surgical experience was significantly lower in older patients (p = 0.01 and 0.02); the authors conclude that patients should be told that submuscular augmentation is associated with delayed recovery of physical functioning.
- Risks and Complications of Breast Implants. U.S. Food and Drug Administration, updated 14 December 2023. fda.gov. — “There is no guarantee that a satisfactory cosmetic outcome will be obtained from any reoperation”; an unsatisfactory result in shape or size, asymmetry, malposition, rippling and implant visibility among the local complications occurring in at least 1% of patients.
- Act 41/2002 of 14 November, the basic act regulating patient autonomy. Consolidated text, BOE. boe.es. — Article 8.5: the patient may freely withdraw their consent in writing at any time. The act establishes no compulsory cooling-off period before the procedure.
Book your consultation
If you are in the first few weeks and you regret it, the most useful thing you can do is not decide anything yet and tell your surgeon at your next appointment: it is a usual and expected conversation. And if six months have passed and it still does not convince you, that is exactly the moment to book an appointment and put it on the table.
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