From the Guidelines
Nexplanon removal should only be performed by a healthcare provider trained in the procedure, and the procedure involves locating the implant, injecting a local anesthetic, making a small incision, and gently pushing the implant toward the incision until it can be grasped and removed with forceps. The removal process typically begins with the provider locating the implant in the arm, usually through palpation or ultrasound if it's not easily felt 1, 2. Once the implant is located, the area is cleaned, and a local anesthetic is injected to numb the skin. A small incision, approximately 2-3mm, is made near the end of the implant. Using a special technique, the provider gently pushes the implant toward the incision until the tip becomes visible, at which point it is grasped with forceps and removed completely. This procedure is relatively quick, taking only a few minutes to complete. After the implant is removed, the incision is closed with surgical strips or a bandage. Some patients may experience bruising or soreness for a few days following the procedure. It's crucial to note that fertility can return quickly after Nexplanon removal, so if pregnancy is not desired, an alternative contraceptive method should be started immediately 1.
Key considerations for the removal procedure include:
- The procedure should be performed under sterile conditions to minimize the risk of infection.
- Patients should be advised on what to expect during and after the procedure, including potential side effects such as bruising or soreness.
- The importance of starting an alternative contraceptive method immediately after removal should be emphasized to prevent unintended pregnancy.
- Patients should be instructed to follow up with their healthcare provider if they experience any complications or have concerns after the procedure.
It's also important to consider the patient's goals and preferences regarding continued use of the implant or its removal, as well as any underlying health conditions that may affect the removal process or the choice of alternative contraceptive methods 2. Never attempt to remove a Nexplanon implant yourself, as this could lead to serious injury, infection, or incomplete removal requiring a more complicated procedure later.