The procedure wasn't painful because the person I went to had some numbing agent that I'm almost certain they weren't supposed to have (by saying this I can't say where I got it done so the body mod artist doesn't get in trouble). I opted for super glue instead of a stitch which also helps in the pain department.
The biggest drawback, as someone who is active, was how sensitive it was to touch. You basically have a hard lump right under some thin skin. I would end up doing push ups with that finger off the ground for a couple of years. If you banged it, it hurt like hell. I got mine removed and my girlfriend got one put in. She got hers removed a few years later. The coating on hers did end up breaking and her skin got a bit discolored where it was.