Breast augmentation has one of the lowest regret rates in elective cosmetic surgery. A 2024 systematic review in the American Journal of Surgery — the most comprehensive available, covering regret across surgical subspecialties — places the breast-augmentation-specific range at 5.1—9.1%, with a midpoint around 7%. This is substantially lower than body contouring (11—33%) and far lower than many non-cosmetic elective procedures. A separate 2024 meta-analysis of 18,322 patients using the validated BREAST-Q instrument found large post-operative improvements in psychosocial well-being, sexual well- being, and breast satisfaction — domain gains that explain why regret remains modest despite the physical risks of the procedure.
The complication picture is more sobering than the regret rate suggests. Capsular contracture — abnormal scar tissue that hardens around the implant — is a well-documented long-term risk: the Sientra 10-year cohort reported a 10.8% Kaplan-Meier rate. Implant rupture occurs in approximately 7.8% of patients at 10 years. Both complications can require revision surgery; the FDA maintains a Breast Implant Registry to track long-term outcomes. Among patients who later underwent explant for implant illness, a multicenter longitudinal study of 156 patients found that 83.3% reported retroactive regret about the original augmentation decision — though this population is a small, highly selected subset with unusually severe complications.
On the inaction side, no published survey directly measures regret among women who considered but chose not to get breast augmentation. The ASDS consumer survey (70% of Americans considering some cosmetic procedure) and the Ipsos body-dissatisfaction figure (37% feel dissatisfied whenever they look in the mirror) are too broad to function as inaction-regret proxies: both conflate general appearance concern with surgical-specific regret. The 5% inaction estimate is a constructed placeholder — a conservative downward adjustment reflecting that persistent, surgery-specific regret is far less common than diffuse body dissatisfaction. The delta (0.02) should be read as “roughly balanced with a slight action tilt,” not as a precise quantitative claim. Unlike most life decisions, where inaction regret dominates over time, breast augmentation joins the small class of decisions — tattoos, cosmetic surgery broadly — where action regret is at least as common as inaction regret, held up by the physical permanence of the result.