Nexplanon removal is a quick, in-office procedure that takes only a few minutes of hands-on time, with the full appointment typically lasting 20 to 30 minutes. A small incision is made near one end of the implant, and the rod is pulled out with forceps. Most people describe it as easier and faster than the original insertion.
What Happens During the Procedure
You’ll lie down with your arm extended and turned so the inner side faces up, just like when the implant was placed. Your clinician will feel for the implant under your skin and mark both ends with a pen. The removal incision is made at the end of the rod closest to your elbow (the “distal” tip).
Before anything else, you’ll get a small injection of local anesthetic at the incision site. This is the only part that stings, and it lasts just a few seconds. The anesthetic is injected underneath the implant on purpose, which numbs the area and also pushes the rod closer to the skin’s surface, making it easier to reach.
Once the area is numb, your clinician makes a small cut in the skin, typically just a few millimeters long. They’ll press on the opposite end of the implant so the tip pops up through the incision. From there, they grasp it with forceps and slide it out. The whole hands-on portion often takes under five minutes. A single stitch isn’t usually needed since the incision is so small. Instead, you’ll get adhesive wound closure strips and a pressure bandage.
Does It Hurt?
The local anesthetic blocks pain at the site, so what most people feel during the procedure is pressure or tugging rather than sharp pain. The numbing injection itself feels like a brief pinch and burn, similar to what you felt during insertion. Some people report that removal is actually less uncomfortable than insertion because the implant is already sitting in a small channel under the skin and slides out smoothly.
After the anesthetic wears off (usually within an hour or two), mild soreness and bruising around the site are normal and can last several days.
When Removal Gets Complicated
Straightforward removals depend on being able to feel the implant through the skin. Most of the time this is easy. But in some cases, the implant can’t be felt by touch, either because it was inserted too deeply, shifted slightly, or because scar tissue formed around it.
The most common complication clinicians encounter is the implant becoming encased in fibrous tissue, a tough layer of scar-like material the body builds around the rod over time. This doesn’t mean anything went wrong. It just means the clinician may need to make a slightly larger incision and carefully separate the tissue to free the implant. In a large study tracking over 5,100 removal procedures, all but one were completed successfully, and that single exception involved an implant lodged in deep muscle tissue.
If your clinician can’t feel the implant at all, they’ll use imaging to find it before attempting removal. High-frequency ultrasound is the first choice and locates the rod reliably in most cases. If ultrasound can’t find it, X-ray or CT imaging can also pick up the implant because the rod is radiopaque (visible on imaging). In these situations, removal is sometimes done by a specialist using real-time ultrasound guidance, which lets them see the rod on a screen while working. Nerve injury from removal is extremely rare. In that same large study, only one case of post-procedure nerve-related pain was reported, and it followed removal of a deeply placed implant.
Aftercare and Healing
You’ll leave the office with two layers of bandaging: a pressure bandage on top and a smaller adhesive bandage underneath. Keep the pressure bandage on for 24 hours to minimize bruising. After you remove it, leave the adhesive bandage in place for 3 to 5 days. Keep the area clean and dry during that time.
Bruising is almost universal and can look dramatic, spreading in a band along your upper arm. It’s cosmetic and fades within one to two weeks. Watch for signs that something isn’t healing normally: increasing pain rather than improving pain, spreading redness, warmth, or swelling at the site. These could signal an infection and warrant a call to your provider.
How Quickly Fertility Returns
Your fertility can return almost immediately. Unlike some other hormonal methods that take weeks or months to clear your system, Nexplanon works by releasing a steady low dose of hormone directly into your bloodstream, and once the rod is out, that source is gone. Ovulation can resume within days. If you don’t want to become pregnant, you’ll need another form of contraception right away. Many people choose to have a new implant placed through the same incision during the same appointment, or switch to a different method the same day.
Timing: When Can You Have It Removed?
You can have Nexplanon removed at any point during its three-year lifespan, for any reason. You don’t need to wait until it expires, and there’s no medical benefit to keeping it in longer than you want it. If you’re approaching the three-year mark and want to continue using the implant, your clinician can remove the old one and insert a new one in a single visit. If the implant has been in place beyond its approved duration, removal is handled the same way.