Most people searching this are asking about the contraceptive arm implant (Nexplanon), and the answer is straightforward: a trained provider removes it in a quick office visit that typically takes less than five minutes. You cannot safely remove it yourself. The procedure requires a small incision after numbing the area, and fertility can return as early as one week afterward.
That said, “implant removal” can also refer to breast implants, dental implants, or orthopedic hardware like plates and screws. Each follows a very different process, so this guide covers all of them.
Contraceptive Implant (Nexplanon) Removal
The arm implant sits just under the skin on the inner side of your upper arm. During a standard removal, your provider numbs the area with local anesthetic, makes a small incision near the tip of the rod, and pushes the implant toward the opening until it can be grasped and pulled out. The whole process is quick, and you’ll feel pressure but not pain.
Most removals are this simple because the implant stays right where it was placed. You can feel it under the skin, and your provider can too. Once it’s out, the incision is closed with a small adhesive strip, and you’re done.
When Removal Gets Complicated
Problems arise when the implant can’t be felt through the skin. This happens when the rod was placed too deeply, shifted position over time, or in rare cases migrated away from the original site entirely. A study of 30 difficult-to-locate implants found that 87% were successfully removed using real-time ultrasound guidance. The cases that failed had something in common: 75% of them involved implants that had sunk below the muscle fascia, compared to only 19% of the successful removals.
If ultrasound can’t find the implant, providers move to other imaging. Nexplanon contains a radiopaque core, meaning it shows up on X-ray and fluoroscopy. For older implant brands without that feature, MRI or even modified mammography techniques have been used. As a last resort, a blood test measuring the hormone the implant releases can confirm whether it’s still in your body at all.
Deeply placed implants sometimes require removal by an interventional radiologist rather than your regular provider. Techniques include using specialized clamps under fluoroscopic guidance or inserting a hook-wire under ultrasound to isolate the implant from surrounding nerves and blood vessels. In extremely rare cases where an implant has migrated into a vein, retrieval involves a catheter-based procedure similar to those used in vascular surgery. Fragmented implants during extraction are documented in the literature but uncommon.
Fertility and Hormonal Changes After Removal
Your body clears the implant’s hormones quickly. According to the manufacturer, pregnancy is possible as early as one week after removal. If you don’t want to become pregnant, you should start another contraceptive method the same day the implant comes out or within the days leading up to removal. Ovulation can resume within the first cycle, so there’s no extended “washout” period like some people expect.
Breast Implant Removal
Breast implant removal (explant surgery) is done under general anesthesia and ranges from a simple procedure to a more complex operation depending on how much tissue comes out with the implant.
The simplest version is a straightforward removal: the surgeon opens the previous incision, takes out the implant, and closes. The scar capsule your body formed around the implant is left in place, and it gradually shrinks on its own. Some surgeons remove the front portion of the capsule at the same time if it has hardened or thickened, which is called a partial capsulectomy.
A total capsulectomy removes the entire scar capsule surrounding the implant. This is more involved, especially when the implant sits behind the chest muscle, because the back wall of the capsule is attached to the ribs. Surgeons sometimes remove the front and back portions separately for better control and safety. When a simultaneous breast lift is planned, the extra access from larger incisions actually makes the capsule removal easier and can lower complication risk.
The term “en bloc” capsulectomy has a specific meaning borrowed from cancer surgery: the implant and its entire surrounding capsule are removed together as one intact unit, without opening the capsule at all. This approach is the standard of care for BIA-ALCL, a rare lymphoma associated with certain textured breast implants. Outside of that diagnosis, whether total capsulectomy is necessary is a decision you and your surgeon make together based on your symptoms, implant condition, and goals.
Insurance Coverage for Explant Surgery
Insurance coverage depends on why you’re having the implants removed. If the removal is medically necessary, for example due to implant rupture, leakage, capsular contracture, infection, or mechanical failure, it’s more likely to be covered. Medicare and most private insurers recognize specific diagnostic codes for these complications. If the removal is considered elective or cosmetic, it’s typically classified as non-covered. Out-of-pocket costs vary widely depending on the surgeon, facility, and whether capsulectomy or breast lift is included.
Dental Implant Removal
A dental implant that has failed, meaning the bone around it never fused properly or has since broken down due to infection, is often easy to remove. In many cases, forceps alone are enough to extract it because the implant is already loose.
Removing an implant that is still firmly integrated into the jawbone is a different challenge. The surgeon uses a hollow cylindrical drill called a trephine bur to cut a ring of bone around the implant, creating a gap that frees it. The bur size is matched to the implant diameter. Once enough bone has been cut away, elevators and forceps are used to lift the implant out. Other tools for this osteotomy include high-speed burs and piezosurgical units, which use ultrasonic vibrations to cut bone while protecting soft tissue.
After removal, the site can often be prepared for a replacement implant, sometimes at the same appointment but more commonly after a healing period that allows bone to regenerate in the empty socket.
Orthopedic Hardware Removal
Plates, screws, rods, and pins used to fix broken bones are designed to stay permanently in most cases. Removal is considered when the hardware causes ongoing problems. The most common reasons include persistent pain at the hardware site, infection, allergic reaction to the metal, nerve irritation, broken hardware, or bones that failed to heal properly. In children and adolescents, hardware is sometimes removed to avoid interfering with bone growth.
The surgery typically revisits the original incision to access the hardware. Recovery depends on which bone was involved and how much hardware is coming out, but it’s generally faster than the original fracture surgery since the bone itself isn’t being repaired.
General Wound Care After Removal Surgery
Regardless of what type of implant was removed, the basics of wound healing follow a similar pattern. Swelling peaks on the second day after surgery, not the first, so don’t be alarmed if the area looks worse before it looks better. Physical activity should be minimized for at least 24 hours to reduce bleeding risk from elevated blood pressure.
For sutured wounds, the pressure bandage typically stays on for the first 24 hours. After that, gently clean the site with mild soap and water, remove any crusting, and apply a thin layer of petroleum jelly or a similar ointment before covering with a non-stick bandage. Repeat this daily. Keeping the wound moist is important: letting a scab form actually worsens scarring because it forces the tissue to heal from the surface down rather than from the bottom up.
Showering is safe after 24 hours, but avoid directing water pressure onto the wound. Smoking significantly impairs healing and worsens scarring, so avoiding it entirely during recovery makes a measurable difference in your outcome.