Contraceptive Implant Placement Technique

Updated: Aug 10, 2016
  • Author: Megan A Brady, MD; Chief Editor: Michel E Rivlin, MD  more...
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Technique

Nexplanon Insertion Technique

The Nexplanon should be removed from its packaging and the applicator held between the thumb and forefingers at the site of the textured area. The transparent protection cap should be removed by sliding it horizontally away from the device (see image below). The implant can be seen by looking into the needle tip. The clinician should sit during this procedure to better view the applicator from the side rather than looking down on the device while standing.

The transparent protection cap should be removed b The transparent protection cap should be removed by sliding it horizontally away from the device.

With the free hand, the practitioner uses countertraction on the skin while inserting the needle at a 30° angle (see image below).

With your free hand, use countertraction on the sk With your free hand, use countertraction on the skin as you insert the needle at a 30 degree angle.

Once the needle has punctured the skin, hold the applicator horizontal to the skin, and tent the skin upward as the entirety of the needle is slid into the subdermal space (see image below).

Once the needle has punctured the skin, hold the a Once the needle has punctured the skin, hold the applicator horizontal to the skin, and tent the skin upwards as you slide the entirety of the needle into the subdermal space.

While holding the applicator in place, the purple slider is unlocked with the clinician’s index finger by pushing the slider downward and backward until it locks (see image below).

While holding the applicator in place, unlock the While holding the applicator in place, unlock the purple slider with your index finger by pushing the slider downwards and backwards until it locks.
At this point the needle is inside the applicator At this point the needle is inside the applicator and the applicator can be removed from the field.

At this point, the needle is inside the applicator and the applicator can be removed from the field. The Nexplanon should immediately be palpated to ensure proper placement, and the applicator needle should be examined to verify that the implant has not been retained. An adhesive dressing should be placed over the insertion site, and the implant should be palpated by the patient before dressings are applied (see image below).

The practitioner and patient should palpate the im The practitioner and patient should palpate the implant immediately after insertion.