The birth control implant (Nexplanon or Implanon) is a highly effective, long-acting reversible contraceptive (LARC) method. This small, flexible rod is inserted just beneath the skin of the inner upper arm, where it continuously prevents pregnancy by releasing a steady, low dose of the progestin hormone etonogestrel. While the implant is designed for durability and is protected by its subdermal placement, many users wonder if the device can break or sustain damage inside the arm.
Understanding the Implant’s Physical Structure
The implant is a flexible rod, approximately 4 centimeters long and 2 millimeters in diameter. It is composed primarily of a medical-grade polymer called ethylene vinyl acetate (EVA), chosen for its resilience and biocompatibility. This polymer encases the core containing the progestin hormone, which is released slowly over the device’s lifespan.
The flexible construction allows the implant to bend and conform to the arm’s natural movements without compromising its function. The device also contains barium sulfate, making it radiopaque (visible on an X-ray) to assist clinicians in locating it for removal or diagnosis. The implant sits in the fat layer beneath the skin on the inner, non-dominant upper arm, a placement that offers significant protection from external forces.
The Likelihood of Implant Damage or Fracture
A complete fracture or separation of the implant is extremely rare due to its flexible polymer composition. The material is designed to withstand the stresses of normal daily activity, including exercise and incidental contact. However, the implant can be physically compromised in rare instances, typically due to significant localized trauma, such as a direct, forceful impact to the insertion site.
More common than a complete break is the implant becoming sharply bent or kinked within the tissue. Reports exist of incomplete fractures occurring after sudden, high-impact force is applied to the arm. Even if bent, the implant may remain structurally intact and continue to release hormones effectively, but any physical change warrants immediate medical evaluation.
Physical changes like bending or breakage are concerning because they can interfere with the consistent, controlled release of the hormone. A fractured device may also cause localized irritation or complicate the removal procedure by making the pieces harder to locate.
Recognizing Signs of Potential Implant Issues
Patients should perform routine self-checks to ensure the implant is in its correct position and retains its smooth, rod-like shape. The most common indication of a potential issue is the inability to easily feel the device under the skin, known as loss of palpability. This can occur if the implant has shifted from its original site or if a failed insertion placed it deeper than intended.
Other physical signs signal compromised integrity. These include feeling a visible bend or kink, noticing the implant feels shorter than its original 4-centimeter length, or feeling a jagged edge instead of the normal smooth rod. Unexplained and persistent pain, swelling, or excessive bruising developing weeks or months after insertion may also suggest localized irritation or damage.
Medical Protocol Following Suspected Damage
If a patient suspects the implant is damaged, has migrated, or is no longer palpable, they must contact a healthcare provider immediately and begin using a non-hormonal backup contraceptive method. The clinician will first attempt to locate the device using palpation of the insertion area. If the implant cannot be felt or if damage is suspected, diagnostic imaging is required to confirm its location and integrity.
Because the implant is radiopaque, a simple X-ray of the upper arm and shoulder is often the first method used to visualize the device and check for fracture or displacement. If the X-ray does not locate the implant, a chest X-ray may be ordered, as rare cases of migration into deeper structures, such as the pulmonary artery, have been reported.
Once the implant’s location and status are confirmed, the next action is typically removal. Specialized techniques may be required if the implant is fragmented or deeply lodged. If the patient wishes to continue this contraceptive method, a new implant can be inserted during the same procedure.