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Implanon insertion is typically done in a health care provider's office. The actual procedure takes just a couple of minutes, though preparation will take about 15 minutes.
During the procedure
You'll lie on your back with the arm that will receive the implant bent at the elbow and positioned near your head. Your health care provider will locate a groove between the biceps and triceps muscles on the inner side of your upper arm. He or she will inject a local anesthetic and then use an applicator to insert the device just beneath your skin, above your large blood vessels and nerves. Inserting the device too deeply will make removal difficult.
After the procedure
Your health care provider will feel your arm to confirm the presence of Implanon and have you do the same. If necessary, he or she may also use an ultrasound to confirm that the device has been inserted. Your health care provider will cover the insertion site with a small bandage. He or she may also apply a pressure bandage to minimize bruising. You can remove the pressure bandage in 24 hours. Keep the small bandage clean and in place for three to five days.
It's common to experience some degree of bruising, pain, scarring or bleeding at the insertion site.
Contact your health care provider if you have:
- Breast lumps
- Heavy, prolonged vaginal bleeding
- Signs or symptoms of a blood clot in your leg, such as persistent pain and swelling in your calf
- Signs or symptoms of a stroke, such as a sudden severe headache, problems with vision or speech, or numbness in an arm or leg
- Signs or symptoms of jaundice, such as yellowing of the skin or whites of the eyes, especially with fever, fatigue, loss of appetite, dark urine or light-colored bowel movements
- Signs or symptoms of an infection at the insertion site, such as tenderness, redness, swelling or discharge
- Symptoms of depression, such as trouble sleeping, fatigue or feeling sad
- Signs or symptoms of pregnancy at any time after Implanon is inserted
Removal
Implanon can prevent pregnancy for up to three years. It must be removed and replaced at the three-year point to continue offering pregnancy protection.
Your health care provider may recommend removing Implanon earlier if you:
- Develop jaundice
- Experience significant depression
To remove the device, your health care provider will inject a local anesthetic in your arm beneath the implant. He or she will make a small incision in your skin and will push the implant toward the incision until the tip is visible and can be grasped with forceps. Your health care provider will then pull out the implant, close the incision and apply a pressure bandage. Implanon removal typically takes less than five minutes.
If you choose, a new device can be implanted as soon as the original device is removed. Be prepared to use another type of contraception right away if you don't have a new device inserted.
- Schorge JO, et al. Contraception and sterilization. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: The McGraw-Hill Companies, Inc.; 2008. http://www.accessmedicine.com/content.aspx?aID=3151449. Accessed Nov. 21, 2011.
- Implanon (prescribing information). Kenilworth, N.J.: Merck & Co., Inc.; 2009. http://www.implanon-usa.com/en/HCP/learn-about-it/full-prescribing-information/index.asp. Accessed Nov. 21, 2011.
- Birth control methods fact sheet. U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm. Accessed Nov. 21, 2011.
- Nexplanon (prescribing information). Kenilworth, N.J.: Merck & Co., Inc.; 2011. http://www.merck.com/product/prescription-products/home.html. Accessed Nov. 21, 2011.
- Darney PD. Etonogestrel contraceptive implant. http://www.uptodate.com/home/index.html. Accessed Nov. 21, 2011.
- Raymond EG. Contraceptive implants. In: Hatcher RA, et al. Contraceptive Technology. 20th ed. New York, N.Y.: Ardent Media, Inc.; 2011:193.
- Etonogestrel implant. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.DrugDetails. Accessed Nov. 18, 2011.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 25, 2011.
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