Will getting a breast augmentation exacerbate my alopecia?

Getting breast implant by themselves should not cause hair loss. That said there are a number of things that can aggravate the condition including general anesthesia. Probably the best person to talk to is your dermatologist or whomever is currently helping you. No one can guarantee that surgery will not aggregate further hair loss. Based on what you describe I’m guessing the risk is fairly low but I don’t think anyone can give you an accurate prediction.
You’ll need to assess the “risk benefit ratio”.
It may be a good idea to at least learn your candidacy for implant augmentation to make sure you understand what the procedure entails. Not everyone seeking implants is a good candidate for the procedure. Understanding your candidacy may potentially help in making the decision one way or the other.
Best,
Mats Hagström MD