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Does It Matter Where Nexplanon Is Inserted?

Reviewed on 11/18/2020
A Nexplanon implant is a long-term and effective birth-control method for women.
A Nexplanon implant is a long-term and effective birth-control method for women.

A Nexplanon implant is a long-term and effective birth-control method for women. In this method, a match-stick sized implant is inserted underneath the skin in the inner upper side of your non-dominant arm, about 8-10 cm (3-4 inch) above the elbow bone.

The particular location of the implant is very important due to the following reasons:

  • Less painful: When it is correctly implanted at the particular part of your arm, it won’t hurt much.
  • Less chance of failure: When the placement of the implant is correct, your chances of getting pregnant are very low, which is less than 1 pregnancy per 100 women who use an implant for 1 year. If it is not placed correctly it may fail and you may become pregnant.
  • Safety assurance: If the implant is inserted in a particular place, it is very much palpable to you, and it means it is alright. If it is implanted deep, it may require an X-ray or ultrasonography to locate it. Mostly, you can feel the implant just under your skin; however, everyone may not be able to feel it. If you notice one day that you no longer feel your implant when you previously could, do not panic, because there is no way to expel the implant or have it come out of your body. If you have concerns or if you want to be assured, you must see your doctor.
  • Protect from moving around: A protective layer of fibrous tissue in your arm naturally holds the implant and stops it from moving around. If the implant is placed deep inside the muscle, there are higher chances that it may move to other organs and cause complications.
  • Less risk: To reduce the risk of injury to nerve or blood vessels, the particular site placement is very important. If the implant is not inserted as per the given instructions, then it can lead to deep and impalpable implants. Deep insertion may risk damage to nerve and blood vessels, migration of the implant, and rarely, insertion into a blood vessel.
  • Less difficult or complex to remove: If an implant is placed very deep, it will be difficult or sometimes impossible for the clinician to remove it after 3 years. Also, it may require many attempts for removal or may require surgery. It may leave more swelling and scarring or may damage blood vessels and nerves while removing.

What is the Nexplanon implant?

Nexplanon is a small, thin, flexible, and matchstick-sized plastic implant device that is placed underneath the skin of your inner upper arm. If you are right-handed, doctors place it in the left arm and vice versa. It is considered a long-acting birth control option for women, to prevent pregnancy for up to 3 years and must be removed after 3 years.

The implant continuously releases a hormone, progestin (etonogestrel), that stops an egg from being released from your ovary, prevents sperms from reaching the egg, and changes the linings of your womb. It also contains a small amount of barium sulfate for its better visibility under X-ray.

What happens during the implantation?

What happens:

  • To avoid infection, proper sterile methods must be used during the insertion of the implant, such as the use of hand hygiene, sterile gloves, and correct skin disinfection.
  • A trained doctor or nurse will give local anesthetics, which will numb the part of your arm where the implant will be inserted.
  • The doctor may mark the insertion point at 8-10 cm (3-4 inches) above the elbow of your inner side of the upper arm (especially the nondominant arm) and another point around 4 cm above as a direction guide.
  • It only takes a few minutes to put in, feels similar to having an injection, and you do not need any stitches.
  • After implantation, you may get bruising at the implant site, which is normal.

Who should not use Nexplanon?

You should not use Nexplanon if you have

What are the possible complications?

Complications include:

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References
WebMD. Nexplanon implant. https://www.webmd.com/drugs/2/drug-156597/nexplanon-subdermal/details

Electronic medicines compendium (emc). Nexplanon 68 mg implant for subdermal use. https://www.medicines.org.uk/emc/product/5720/smpc#gref

FDA approved patient labeling. https://www.merck.com/product/usa/pi_circulars/n/nexplanon/nexplanon_ppi.pdf

Australian Family Physician. Implanon NXT: Expert tips for best-practice insertion and removal. https://www.racgp.org.au/afp/2017/march/implanon-nxt-expert-tips-for-best-practice-insertion-and-removal/

NHS. Contraceptive implant. https://www.nhs.uk/conditions/contraception/contraceptive-implant/

Planned Parenthood. Birth Control Implant. https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon

Mayoclinic. Contraceptive implant. https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619

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