BACKGROUND: Despite the popularity of breast augmentation, limited information is available evaluating this procedure from the patient's perspective. No existing studies assess patient-reported data prospectively in a large number of consecutive patients with a high inclusion rate, as required by evidence-based medicine. This prospective outcome study was undertaken to obtain this information. METHODS: Over a 5-year period, 281 consecutive women underwent breast augmentation performed by the author. In-person interviews were conducted at least 1 month after surgery among 225 women (response rate, 80.1 percent). All implants, predominantly saline-filled, were placed submuscularly using primarily inframammary incisions. Questions were asked in six categories: patient data, indications, recovery, results, complications, and psychological effects. A follow-up study evaluated subjective nipple numbness. RESULTS: The mean implant volume was approximately 390 cc. The mean pain rating was 5.9 on a scale of 1 to 10. The mean time off work was 6.6 days. The mean result rating was 9.3 on a scale of 1 to 10. Expectations were met or exceeded in 98.1 percent of patients. Satisfactory size was achieved in 85.5 percent of patients and satisfactory firmness was achieved in 75.7 percent. The reported complication rate was 10.2 percent. Breast self-consciousness decreased from 86.2 percent to 12.6 percent (p < 0.001). The result rating correlated with a low rate of complications (p < 0.001). CONCLUSIONS: Breast augmentation improves self-esteem (91.1 percent) and quality of life (64.3 percent). Nipple numbness is common (39.1 percent), but persistent numbness is unusual (2.3 percent). Almost all patients (98.7 percent) would repeat the surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.