Implants: The Next Generation

What Clients Should Know About Insertion and Removal

A client who has chosen implants needs to know what will happen during the insertion and removal procedures. Explaining the following important steps in the procedures tells the client what to expect (67, 69, 99, 124).

Insertion:

Removal:

1 The woman receives an injection of local anesthetic under the skin of her arm to prevent pain while the implants are being inserted. This injection may sting. She stays fully awake throughout the procedure.

1 The woman receives an injection of local anesthetic under the skin of her arm to prevent pain while the implants are being removed. This injection may sting. She stays fully awake throughout the procedure.

2 For Jadelle and Sino-Implant (II), the provider makes a small incision and inserts the implants just under the skin. Alternatively, the provider uses the trocar to puncture the skin and insert the implants, without the need for an incision. The woman may feel some pressure or tugging during insertion. With Implanon, there is no incision. The provider uses a special insertion applicator with a needle that punctures the skin and inserts the implant.

2 During removal the provider makes a small incision and uses an instrument (forceps or small tongs) to pull out each implant. The woman might feel some pressure or tugging and slight pain during the procedure and for a few days after.

3 After either procedure the provider closes the incision with an adhesive bandage. Stitches are not needed. The incision is covered with a dry cloth, and the arm is wrapped with gauze. Alternatively, two adhesive bandages can be used, one crossed over the other over the incision.

3 After removal the provider closes the incision with an adhesive bandage. Stitches are usually not needed. An elastic bandage may be placed over the adhesive bandage to apply gentle pressure for two or three days and keep down the swelling.

4 After implant insertion a provider tells the woman when she should return to have the implants replaced or else removed in favor of another method. She may be given a reminder card listing the type of implant she has, the date of insertion, the month and year when the implants will need to be removed or replaced, and where to go if she has problems or questions.

4 If a woman wants new implants immediately after her current implants are removed, they can be placed above or below the site of the previous implants or in the other arm. With Implanon, the incision that was made for removal can also be used to insert the new implant.

5 After insertion she should keep the insertion area dry. She can take off the elastic bandage or gauze after two days and the adhesive bandage after five days.

5 Return to fertility is immediate, so inform the client that if she does not get another implant or use another method, she could get pregnant immediately after removal.

6 After the anesthetic wears off, her arm may be sore for a few days. She also may have swelling and bruising at the insertion site. This is common and will go away without treatment.

7 The contraceptive effect starts within 24 hours.