Remove and replace or leave alone? Re-augmentation nearly 3 years ago. (photos)

You need to go back to your surgeon and have the implant removed. You probably have some bacteria around the implant and inside the capsule. The implant needs to be removed to remove all foreign material so that the infection can be completely healed. Once healed, a new implant can be replaced. If not removed, this problem may go on for a while and you will develop a hard capsule on that side which will require surgery. Do surgery now.

Generally speaking an implant that is contaminated is going to need to be removed.
In most instances a contaminated foreign body will not clear the bacteria with the use of antibiotics.
There have been a few documented instances where contaminated implants have been cleared of bacteria, using antibiotic ongoing irrigation.
The problem with leaving the implant in place is that bacteria will slowly errode the tissues.
When patient stopped taking antibiotics the infection will flare up again. if the body has the ability to drain the fluid, then signs of infection may be less.
The opening will never heal if there is contamination.
You should be in a close contact with your plastic surgeon hopefully has enough skill and experience to properly manage an infected implant.
Best,
Mats Hagstrom MD