Can a Nexplanon (etonogestrel) implant be permanently left in the arm?

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Last updated: April 29, 2025View editorial policy

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From the Guidelines

No, a Nexplanon implant should not be permanently left in your arm. The most recent and highest quality study, 1, indicates that Nexplanon is approved for use for up to 3 years, with some evidence suggesting extended use. However, it is crucial to remove and replace the implant after its approved duration to ensure continued effectiveness and prevent potential complications. Some key points to consider:

  • The implant contains etonogestrel, a hormone that gradually depletes over time, making it ineffective for pregnancy prevention beyond its approved duration 1.
  • Leaving the implant in indefinitely could potentially lead to complications such as migration of the device, difficulty with future removal, or unknown long-term effects.
  • The removal procedure is relatively quick, typically taking 5-10 minutes in a healthcare provider's office using local anesthesia.
  • If you're approaching the end of your implant's effective period, you should schedule an appointment with your healthcare provider to discuss removal and your contraceptive options going forward.
  • Some patients experience side effects from the implant that might warrant earlier removal, including irregular bleeding, headaches, mood changes, or weight gain 1. It is essential to prioritize your health and well-being by following the recommended guidelines for Nexplanon use and removal.

From the Research

Nexplanon Implant Removal

  • The Nexplanon implant is designed to be removed after three years of use 2
  • If the implant is not removed, it can potentially migrate to other parts of the body, such as the axillary region or even the pulmonary artery 3, 4, 5
  • In cases where the implant migrates, it may be necessary to use imaging techniques, such as x-rays or CT scans, to locate the implant before removal 3, 5
  • Removal of the implant can be done through standard or modified techniques, depending on the location of the implant 3
  • In rare cases, surgical removal may be necessary, such as when the implant migrates to the biceps brachii muscle or the pulmonary artery 4, 5

Complications of Nexplanon Implant

  • Implant migration is a rare complication, but it can potentially cause damage to surrounding tissues or nerves 4, 5
  • If the implant becomes non-palpable, it is essential to visualize it with imaging to prevent further complications 4
  • The implant can embolize into the pulmonary vasculature, requiring surgical removal in some cases 5

Recommendations for Nexplanon Implant Use

  • The implant should be removed by the end of the third year of use to avoid potential complications 2
  • Healthcare providers should be trained on Nexplanon insertion and removal procedures to minimize the risk of complications 2
  • Patients should be aware of the potential risks and complications associated with the Nexplanon implant, including implant migration and the need for surgical removal in rare cases 3, 4, 5

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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