Can an old Implanon (etonogestrel implant) be removed and a new one inserted at the same time?

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Last updated: December 19, 2025View editorial policy

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Implanon Removal and Immediate Reinsertion

Yes, an old Implanon can be removed and a new one inserted immediately at the same time through the same incision. This is the recommended approach to maintain continuous contraceptive coverage without gaps 1.

Procedure Details

The CDC explicitly recommends that if a woman wishes to continue using the contraceptive implant, a new implant can be inserted immediately after removal of the old implant through the same incision used for removal 1. This approach offers several advantages:

  • No gap in contraceptive protection occurs when the new implant is placed immediately, eliminating the need for backup contraception 1
  • Single procedure reduces patient visits and minimizes repeated local anesthesia and incisions 2, 3
  • Immediate continuation ensures no interruption in hormonal contraception, which is particularly important since fertility returns rapidly after implant removal 4

Timing and Contraceptive Coverage

When performing same-day removal and reinsertion:

  • No additional backup contraception is needed if the new implant is inserted immediately after removing the old one 1
  • The procedure can be performed at any time during the menstrual cycle 1
  • No waiting period is necessary between removal and reinsertion 1

Clinical Considerations

The implant removal and insertion process is straightforward:

  • Removal takes approximately 2.6 minutes on average using the "pop out" technique through a 2-mm incision 2, 3
  • Insertion takes approximately 1.1 minutes using the pre-loaded applicator 2, 3
  • Complications are rare, with removal complications occurring in only 0.2% of cases 2

Important Caveats

Do not perform the procedure if active infection is present at the removal site 1. This is the primary contraindication to same-day removal and reinsertion.

  • Ensure you have the new implant available at the time of removal to avoid gaps in contraceptive coverage 1
  • Transient nerve injury during removal is rare but possible 1
  • The implant contains barium sulfate and is visible on radiography if localization is needed 1

References

Guideline

Nexplanon Removal Procedure

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Insertion and removal of Implanon: practical considerations.

The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2000

Research

Implanon: a new contraceptive implant.

Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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