Is There a Lot of Swelling After a Breast Implant Exchange?

This really depends on the extent of the surgery.  If is just an exchange, same size should be minimal to none.  If the pocket is manipulated to accommodate a larger implant than the issue is what took place in the pocket,  If a capsulotomy, just opening the pocket, should not be major swelling.  If a capsulectomy, removing the scar tissue surrounding the implant, than I would expect more swelling.  I dress my patients after surgery with ace bandages circumferentially as a tube top and this helps to minimize swelling,

Usually there is less than after the initial surgery as a pocket is already present. But if there is a lot of dissection necessary to make the pocket larger or the capsule is being removed, there can be significant swelling. Your doctor should be able to give you some idea of how much swelling you should expect.