Boob jobs have often been a problem for me...personally and professionally. (I'm a photographer - I shoot mostly nude figure with genetic females for art galleries and exhibitions - so I keep a low profile when it comes to my "adult work" side, regardless of whether it's transgenedered or genetic.) Persoanlly, I just prefer natural tits. I think that's one reason hazel turner and Harley Quinn drive me freakin' bonkers!
But, the surgeries are getting better. There was a time when I wouldn't even consider a model for a project if she'd had her tits done. I've seen some absolutely horriffic outcomes over the years. Now, I sometimes can't tell the difference, not by looking or by touching (with permission, of course!
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As with most things, you get what you pay for. It helps too, when someone doesn't go from a natural AA or A to a DDD. Also, the patient's own responsibilities for post surgical care can play a major role as to the quality of the final results.