Standard Implant Removal: No Stitches Needed
For the vast majority of cases, removing a contraceptive implant like Nexplanon is a straightforward, minor procedure that does not require stitches. When the implant is located easily by palpating the skin, the process is quick and minimally invasive.
The Routine Removal Process
Your healthcare provider will follow a standard protocol for removal:
- Local Anesthesia: The area is numbed using a local anesthetic so you do not feel pain during the procedure.
- Small Incision: A tiny incision, often just a few millimeters long, is made at the tip of the implant.
- Extraction: The implant is gently pushed toward the incision and removed with small forceps.
- Closure: The incision is typically covered with small, adhesive strips called steri-strips, followed by a pressure bandage to minimize bruising.
In this routine scenario, the steri-strips hold the incision edges together as the wound heals, and no surgical stitches are required. The process takes only a few minutes, and recovery is fast.
Complex Implant Removal: When Stitches Are Necessary
Though infrequent, some situations can complicate the removal and necessitate stitches. These cases involve implants that are not easily palpable or have migrated from their original insertion site.
Factors That Complicate Removal
- Deep Placement: If the implant was inserted too deeply into the muscle tissue rather than just under the skin, it can be hard to locate and remove through a standard incision.
- Migration: Over time, an implant can move from its insertion point. An ultrasound might be needed to locate its current position.
- Scar Tissue: If an excessive amount of scar tissue has built up around the implant, it may become embedded and more difficult to extract.
The Complex Removal Process
For these difficult cases, the procedure is different:
- Specialist Referral: The initial provider may refer you to a specialist team, such as a plastic surgery team, with more experience handling complicated removals.
- Larger Incision: A larger incision, up to 1.5 to 2 cm, may be required to access the implant, especially if an ultrasound is used to guide the procedure.
- Sutures (Stitches): Because the incision is larger, stitches are often needed to close the wound properly. These may be dissolvable or require a follow-up appointment for removal.
Comparison of Removal Procedures
| Feature | Standard Removal | Complex Removal |
|---|---|---|
| Incision Size | Very small, a few millimeters | Larger, up to 1.5-2 cm |
| Suture Use | No stitches used | Stitches often needed |
| Closure Method | Steri-strips and pressure bandage | Stitches and pressure bandage |
| Procedure Time | Typically under 5 minutes | Longer, depending on complexity |
| Expertise | General practitioner or trained nurse | Specialist team (e.g., plastic surgery) |
| Risk of Bruising | Minor bruising is common | Potentially more bruising due to deeper access |
| Healing Time | A few days for incision; bruising fades | Potentially longer due to stitches |
Aftercare and Recovery
Proper aftercare is essential for a smooth healing process, regardless of whether you received stitches or steri-strips.
Initial Care (First 24-48 Hours)
- Pressure Bandage: A tight pressure bandage is usually applied to minimize swelling and bruising. Keep this on for at least 24 hours.
- Keep it Dry: Avoid getting the wound wet. If stitches are involved, a longer dry period (3-5 days) may be necessary.
Continued Care (First Week)
- Steri-Strips: For a standard removal, leave steri-strips on until they fall off naturally. You can trim curling edges.
- Stitches: If you have stitches, follow your provider's instructions. You may need to book a follow-up appointment for their removal, typically 7-10 days after the procedure.
- Avoid Strenuous Activity: Limit heavy lifting or intense arm movements for a few days to a week to allow the wound to heal properly.
- Monitor for Infection: Watch for signs of infection, such as increasing pain, redness, warmth, or pus. Contact your provider if you notice these symptoms.
For more detailed information on contraceptive implants, consult an authoritative source such as the Cleveland Clinic website.
What to Expect During Removal
Knowing what to expect can help ease any anxiety about the procedure. Your provider will discuss the process with you beforehand, but the key is that local anesthetic will ensure you are comfortable. In most cases, the feeling is only a slight tugging sensation as the implant is removed. For complex removals, the provider will walk you through the extended procedure and why it is necessary.
What if a New Implant is Inserted?
If you are having a new implant inserted, your provider can often place it in the same arm, sometimes in the same incision site, immediately after the old one is removed. This streamlines the process and ensures continuous contraceptive coverage. The aftercare for the new insertion site is similar to a routine removal. Your provider will discuss this option with you during your appointment. You should always confirm your wishes with your healthcare provider regarding continuation of your birth control method.
