The Nexplanon implant is a highly effective, long-acting reversible contraceptive (LARC). Removal is a minor outpatient procedure performed in a healthcare provider’s office, involving a small incision on the inner side of the upper arm that is then closed. Post-procedure care is straightforward but important for minimizing the risk of infection, reducing bruising, and ensuring the site heals correctly.
Understanding the Removal Site and Dressing
The removal of the Nexplanon implant is accomplished through a small incision, typically 2 to 3 millimeters long, made after the area has been numbed with a local anesthetic. This opening is then closed, often using small adhesive strips known as steri-strips, or sometimes a single dissolvable stitch. These inner closures secure the skin edges together to promote healing.
A small bandage or gauze is placed directly over the steri-strips, and then a larger compression or pressure bandage is wrapped around the upper arm. This outer pressure bandage applies gentle, constant force to the site. This pressure helps to minimize bleeding immediately following the procedure and significantly reduces bruising and swelling. Most providers instruct patients to keep this pressure bandage in place for at least 24 hours.
Specific Guidance on Showering and Water Exposure
The most common recommendation for showering is to wait until the initial pressure bandage has been removed, which is usually after a full 24 hours. Water exposure must be avoided during this first day to prevent the pressure dressing from becoming wet. A wet dressing compromises its function and increases the risk of infection. If the bandage gets wet, it should be kept dry, sometimes by covering it with an impermeable layer during washing.
After the initial 24-hour period, you can remove the outer pressure bandage and take a quick, careful shower. It is important to keep the remaining inner bandage—the steri-strips and small plaster—clean and dry for 3 to 5 days total to protect the incision. When showering, avoid directing the water spray forcefully onto the site. Gently pat the area dry instead of rubbing.
Soaking the wound should be avoided completely for 5 to 7 days, even after the outer bandage is off. This means avoiding activities like taking a bath, swimming in pools, or using hot tubs. Submerging the incision site for an extended period can soften the skin and lift the steri-strips. This makes the wound vulnerable to bacteria, potentially leading to infection.
Complete Recovery: Activity, Healing, and Warning Signs
Following the removal, restrict certain physical activities to ensure the small incision heals properly. Avoid strenuous exercise, heavy lifting, or any activity that puts significant strain on the arm for at least 48 to 72 hours. This minimizes movement at the incision site and helps prevent the steri-strips from peeling off prematurely.
Mild tenderness, minor pain, and bruising around the removal site are common and expected. Bruising may be noticeable for up to two weeks, and over-the-counter pain relievers may be taken if necessary. The incision is usually fully closed within 5 to 7 days. At this point, the steri-strips can be gently removed, often by soaking them in the shower.
While complications are rare, it is important to monitor the site for specific warning signs that could indicate an infection. These signs include worsening pain, a fever, an increase in redness or swelling that spreads out from the incision, or any discharge of pus or fluid from the wound. If you experience any of these symptoms, or if you notice numbness, tingling, or shooting pain in your arm or hand, you should contact your healthcare provider promptly.