The implant birth control is a small, flexible rod, approximately the size of a matchstick, placed just beneath the skin on the inner side of the upper arm. This device continuously releases a progestin hormone to prevent pregnancy, offering effective contraception for three to five years depending on the specific product. Removal ends its contraceptive effect, either because it has reached the end of its approved lifespan or because the user wishes to discontinue its use. The removal process is a minor, in-office procedure.
Preparation and Timing for Removal
The implant must be removed by the end of its approved period, typically three or five years, to prevent unintended pregnancy. A person can request removal at any time before the expiration date, and healthcare providers should not delay or refuse this request. The procedure should be performed by a qualified healthcare professional, such as an obstetrician-gynecologist, a trained family medicine physician, or a clinician at a specialized clinic.
During the consultation, the healthcare provider will discuss future family planning goals and contraceptive options. Since fertility can return rapidly after removal, it is important to have a plan for a new birth control method if pregnancy is not desired. The new method, such as a different hormonal option or an intrauterine device, can often be started immediately following the implant’s extraction. Patients should inform their provider of any allergies, such as to latex or local anesthetics, before the procedure begins.
The Standard Removal Procedure
The routine removal is a quick, outpatient procedure, usually taking less than five minutes once the area is prepared. The patient lies on their back with the arm bent, placing the hand near the head to expose the insertion site. The clinician first locates the implant by gently feeling the skin, confirming its exact position beneath the surface.
A local anesthetic, typically 1% lidocaine, is injected just under the implant to numb the area, causing only a brief stinging sensation. The provider then stabilizes the rod and makes a small incision, usually about 2 millimeters, near the end closest to the elbow. The tip of the implant is gently pushed toward the incision until it becomes visible.
Using forceps or a specialized clamp, the provider grasps the tip of the rod and removes it entirely. If the implant is encased in fibrous tissue, the provider may use the back of a scalpel blade or gauze to gently separate the tissue. Once the implant is confirmed to be out, the small incision is closed, often with adhesive strips or a single suture, and a pressure bandage is applied to minimize bruising.
Addressing Difficult or Non-Palpable Implants
While most removals are straightforward, some implants may be difficult to locate or extract due to factors like deep insertion, migration, or significant weight gain. An implant that cannot be easily felt through the skin is called non-palpable, and the provider should not attempt a blind removal. Imaging is necessary in these cases to pinpoint the exact location and depth of the device.
The provider will typically use high-resolution ultrasound to locate the implant, as it can be visualized in the soft tissue. If ultrasound is inconclusive, an X-ray may be used, since modern implants are designed to be radiopaque for detection. Once located, the provider will mark the site. The removal may require a more specialized technique or a slightly larger incision, sometimes up to 5 to 10 millimeters, to ensure safe extraction. For implants that are deeply embedded, or near nerves or blood vessels, the patient may be referred to a specialist or surgeon to minimize the risk of complications.
Immediate Post-Removal Effects and Follow-Up Care
After the procedure, the patient will receive instructions on caring for the removal site, including keeping the area clean and dry for a few days. The pressure bandage should be kept on for at least 24 hours to reduce bruising and swelling. Minor tenderness, bruising, or a small, temporary lump at the site is common and should resolve within a week or two.
A significant effect following removal is the rapid decline of the synthetic hormone in the bloodstream. Hormonal side effects experienced during use, such as changes in bleeding patterns or mood fluctuations, will begin to subside. Fertility returns very quickly, often within a week after removal, as hormonal levels become virtually undetectable.
For those not seeking pregnancy, a new contraceptive method must be started immediately, ideally on the same day as the removal. A follow-up appointment is generally not required unless there are signs of infection at the site, such as increasing redness, warmth, or discharge, or if the patient experiences unusual or persistent pain. Most people find that their pre-implant menstrual cycle pattern returns within one to three months.