By: Ovation Obstetrics & Gynecology:
Nexplanon Birth Control: What to Expect with Placement and Removal
A Patient Guide from Ovation OB/GYN
Choosing a birth control method is a personal decision, and long-acting options like Nexplanon offer a highly effective, low-maintenance alternative to daily pills or monthly rings. Whether you’re considering Nexplanon for the first time, approaching the end of your current implant’s effectiveness, or planning its removal, it helps to understand what the process involves — from placement and aftercare to removal and future options. At Ovation OB/GYN, we aim to provide clear, comprehensive information to support you through each step of your reproductive health care.
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What Is Nexplanon?
Nexplanon is a small, flexible hormonal implant placed under the skin of your upper arm. It releases a continuous, low dose of etonogestrel, a progestin hormone that prevents pregnancy by stopping ovulation, thickening cervical mucus, and altering the uterine lining. The implant is one of the most effective contraceptive methods available, with a greater than 99 percent effectiveness rate when properly inserted.
Nexplanon is designed to provide reliable birth control for up to three years. After this period, it must be removed, although you can have it removed earlier if your needs or circumstances change.
Deciding on Placement
Your Ovation OB/GYN provider will discuss whether Nexplanon is a suitable option for you based on your health history, reproductive goals, and any contraindications (such as certain hormone-sensitive conditions). Nexplanon is generally appropriate for most healthy women and can be used by people of reproductive age who want long-term contraception without daily attention.
It’s important that you are not pregnant at the time of placement. If you are transitioning from another form of contraception, your clinician will review the timing to ensure a smooth changeover.
The implant should ideally be placed within the first few days of your menstrual cycle for immediate contraceptive protection; if placed later in the cycle, your provider will recommend using backup birth control (such as condoms) for the first seven days.
What Happens During Placement
Nexplanon placement is a minor in-office procedure that usually takes only a few minutes. Your provider will:
- Prepare the site: The inner, non-dominant upper arm is cleaned and covered with a sterile drape.
- Administer local anesthesia: A numbing injection is given just under the skin to minimize discomfort during the procedure.
- Insert the implant: Using a specially designed applicator, the trained provider places the flexible rod just beneath the skin. You should feel only pressure, not pain, during insertion.
After placement, your clinician will check that the implant is correctly positioned and then cover the site with a pressure bandage to reduce the chance of bruising. After 24 hours, you remove the pressure bandage and replace it with a smaller adhesive bandage for several more days as the site heals.
After Placement: What to Expect
It’s common to feel mild tenderness, bruising, or swelling near the insertion site as your arm heals. These effects typically resolve in a few days. Because every individual responds differently to hormones, you may also notice changes in your menstrual patterns, including lighter bleeding, irregular spotting, or even an absence of periods. These changes are not harmful but can vary from person to person.
If you have any unexpected or severe symptoms after placement — such as significant pain, signs of infection, or inability to feel the implant under your skin — contact your clinician right away.
When and Why Removal Is Scheduled
Nexplanon must be removed by the end of the third year after placement. This is because the hormone levels eventually decline below the level needed for effective pregnancy prevention.
Your provider can also remove the implant at any time before that date if you choose to stop using it — for example, if you plan to become pregnant, experience unacceptable side effects, or prefer a different contraceptive method.
If you wish to continue using Nexplanon beyond the three-year period, your clinician can remove the old device and insert a new one during the same visit.
What Happens During Removal
Removal, like placement, is done in the office under local anesthesia and typically takes less than five minutes. Your provider will:
- Numb the area: An injection of local anesthetic ensures the site is numb.
- Make a small incision: A tiny cut is made directly over the implant.
- Extract the implant: The implant is gently pushed toward the incision and removed.
- Dress the site: A pressure bandage is applied to minimize bleeding and bruising.
After removal, you may experience mild soreness or bruising, but these symptoms generally resolve quickly. Follow-up care includes keeping the area clean and covered, with pressure bandages worn as directed to support healing.
What to Know After Removal
Once the implant is removed, your body’s hormone levels begin to return to their pre-implant state. Fertility may return almost immediately, so if you are not planning to become pregnant, discuss your next birth control option with your clinician before removal or start another method promptly.
Any side effects you experienced while using Nexplanon — such as changes in menstrual bleeding — should gradually resolve after the implant is taken out.
Risks and Considerations
While Nexplanon is safe and highly effective for most users, all procedures carry some risk. Possible complications include infection at the insertion site, bruising, swelling, or, rarely, difficulty with placement or removal if the implant is not placed correctly. Discuss any health conditions or concerns with your provider before placement.
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Nexplanon offers a reliable, low-maintenance option for long-term birth control with a simple placement and removal process. Understanding what to expect — from the day of insertion to the day of removal — can help you feel confident and prepared as you make decisions about your reproductive health.
If you have questions about Nexplanon placement or removal, or want to explore whether this contraceptive option is right for you, Ovation OB/GYN is here to support you with personalized care and expert guidance.