Nexplanon removal is a quick in-office procedure that typically takes 3 to 5 minutes from the first incision to the implant coming out. Including the time for numbing the skin and cleaning the area, the entire appointment usually runs about 15 to 20 minutes. It’s significantly faster than the insertion was, and most people describe it as surprisingly simple.
What Happens During Removal
Your provider will first feel for the implant in your upper arm to locate the tip closest to your elbow. After cleaning the skin, they inject a small amount of local anesthetic (less than 1 ml) into the skin right over that tip. This numbs the area within a minute or two, so the rest of the process is painless.
Next, the provider makes a tiny incision, about 2 millimeters long, directly over the end of the implant. They then press gently on the opposite end of the rod to push the tip up through the incision, a technique sometimes called “pop-out.” Once the tip is visible, they grasp it with gloved fingers and slide the implant out. The entire rod is 4 cm long, and your provider will typically measure it afterward to confirm it came out in one piece.
In some cases, a thin layer of tissue has formed around the implant over the years. If that happens, the provider makes a small cut through that tissue sheath so the rod can be pushed free. This adds a minute or two but is still straightforward. Forceps are occasionally used if the implant is harder to grip, though only when the rod is already visible at the incision site.
When Removal Takes Longer
The timeline above applies when the implant can be easily felt under the skin, which is the case for most people. Occasionally, an implant migrates slightly or sits deeper than expected, making it difficult to locate by touch. When a provider can’t feel the rod, they’ll use ultrasound to pinpoint its position before attempting removal.
Deep or non-palpable implants sometimes require a slightly larger incision and more careful dissection of tissue to reach the rod. If the implant has shifted close to nerves or blood vessels, your provider may refer you to a specialist for the procedure. These cases are uncommon, but they can turn a 5-minute removal into a longer appointment. Your provider will let you know beforehand if imaging suggests a more involved removal.
Recovery and Healing Timeline
The numbness around the removal site wears off within 2 to 3 hours. After that, you may feel mild soreness, which over-the-counter pain relievers can handle. Bruising is common and clears up within a few weeks. A small scar will form at the incision site and fade over time.
You’ll leave the office with a pressure bandage, which should stay on for at least 48 hours. Underneath, adhesive strips hold the tiny incision closed. Keep those strips in place for 3 to 5 days, and keep the site dry during that period. Soaking the strips off in the shower or bath after that timeframe is the easiest way to remove them. If you notice increasing swelling, redness, or any discharge from the site, contact your provider.
Avoid strenuous activity and heavy lifting for a few days after the procedure. Light daily tasks are fine right away. Most people feel completely back to normal within a week.
Fertility Returns Immediately
Unlike some other forms of birth control, there’s no waiting period for fertility after Nexplanon removal. It’s possible to get pregnant right away, because the synthetic hormone that was suppressing ovulation leaves your system quickly once the rod is out. If you don’t want to become pregnant, start using another form of contraception immediately.
Getting a New Implant at the Same Visit
If you want to continue using Nexplanon, you can have a new implant placed during the same appointment. There’s no required gap between removal and reinsertion. The new rod is typically inserted through the same incision or a nearby site, which saves you from scheduling a second visit. Let your provider know ahead of time so they can have a new implant ready. A combined removal-and-insertion appointment runs slightly longer, usually around 20 to 30 minutes total.