I don’t have a foreskin so the experience may be different for you.
1. I hurt for a few seconds while it was done to me
2. Recovery took very little time and after. A few hours there was no sign of blood or that anything had happened there.
The actual piercing will probably prevent you from having sex for a month and it may be painful when tweaked or moved.
Mine took about three months to properly settle but then I wanted to have a larger ring as I don’t feel that anything less than 3mm is safe for play (as a thin one will tare the skin more easily).
Any downside? Yes, some people say that they won’t play with people with a PA because they don’t want metal in their mouth. However, the solution is simple:- remove the ring for we with them and reinserted afterward.