I have found that pain after virtually all cosmetic surgeries is very subjective. There are a few factors that I believe effect a woman's perception of pain after breast augmentation. If a woman is "happy" and "eager" before her surgery, she usually has very little pain, and she frequently describes her sensation as "pressure", and not pain. This type of woman frequently takes a dose or two of a prescription pain pill, then either changes to Tylenol, or discontinues oral medication entirely. If a woman is very "anxious" and "nervous" about her surgery, she always seems to require more pain medication. So preoperatively, I discuss this observation and suggest the patient put herself in a "happy state of mind", so she has a greater likelihood that she will only have "pressure" and not "pain". Sometimes this type of patient can benefit from a prescription of a low dose anti-anxiety medication. Regardless of which type of patient a woman may be, I always give a pain med prescription, but many tell me they hardly used them.
Another factor that parallels that mentioned above is the current "psyche" of the woman.....is something bad going on in her life (recent loved one's illness, job uncertainty, etc.), then she may be more likely to be in the "anxious" and "nervous" category, even if it is not the surgery that is causing that mental state.
Of course, one's expectations always adds to a woman's pain perception. If a woman has a friend that told her it was painful, she will be more likely to have pain. Or if she is told by a friend she doesn't understand why she would want to "have a boob job", that negative opinion can also negatively effect how one perceives post operative "discomfort". So I always tell my patient to surround herself with friends or family that have "positive attitudes" toward her decision to have breast implants.
Finally, there are a few technical factors that may effect post op discomfort. Some patients that have sub pectoral implants may have slightly more "pain" than those who have sub mammary implants, although I find the "subjective" factors to out weigh the implant position. And post op activities can also have an effect. I usually restrict my patient's arm movements (i.e., I ask her to keep her upper arms by her chest). This limits motion of the muscle or of the tissues around the muscle, thereby decreasing the chance for significant pain. After a week, the healing has had significant time to diminish the sensation of the immediate perioperative discomfort and resuming normal arm motions is not an uncomfortable sensation.
Here's to your "positive attitude" preop and very little discomfort postop!