A multi-year, retrospective review identified patients with peri-prosthetic infections and threatened or actual breast implant exposure to determine etiology, treatment strategies and outcome. Patients with infection are placed on antibiotics; those that respond completely require no further treatment. If mild infection persists or threatened or actual exposure exists, operative intervention is required. No immediate salvage is attempted in cases of severe, non-responding infection with gross pus, marginal tissues, or absence of options for healthy tissue coverage. Twenty of 26 (76.9%) implants with threatened or actual prosthesis exposure with or without infection were salvaged after aggressive intervention. In those patients with no or low-grade infection only, successful salvage was achieved in 18 of 19 (95%) patients while those patients with severe infection, were salvage in only 2 of 7 (29%) patients. Threatened or actual device exposure, not complicated by severe infection, was salvaged in 10 of 11 (91%) patients. The authors found that the infected or exposed breast prosthesis may be salvaged except in cases of overwhelming infection or deficient soft tissue coverage. Based upon this experience, patients may be offered the option of attempted implant salvage, although device removal remains a more conservative and predictable option.