In-Office Procedures
In-Office · No Hospital · No General Anesthesia

Nexplanon
Insertion & Removal
The 3-year arm implant — inserted and removed in the office under local anesthetic. No surgery, no hospital.

Schedule a Gynecologic Visit
5–10 Min
Procedure Time
Local
Anesthesia
Same-Day
Return to Activity
>99%
Contraceptive Efficacy
Procedure
Nexplanon Insertion or Removal
Setting
In-Office · No Hospital
Anesthesia
Local Only
Duration
5–10 Minutes
Effectiveness
>99% for 3 Years
In-Office Procedures

Nexplanon: The 3-Year Arm Implant — Inserted and Removed In the Office

Nexplanon is a small, flexible contraceptive implant — about the size of a matchstick — placed just beneath the skin of the upper inner arm. It releases a low, steady dose of etonogestrel (a progestin) to prevent pregnancy for up to three years with greater than 99% effectiveness. Dr. Andrei inserts and removes all Nexplanon implants as in-office procedures at Lapeer Women’s Health.

Insertion takes 5–10 minutes using a pre-loaded applicator under local anesthetic. No incision is required — the applicator places the implant through a small needle entry point that is covered with a bandage. Once inserted, the implant is not visible and is rarely felt in daily life.

Removal is equally straightforward: local anesthetic at the insertion site, a small incision, and the implant is grasped and removed in minutes. Fertility returns rapidly after removal. Removal and same-visit replacement with a new implant can be performed in a single appointment for patients at the end of their three-year term.

Who Is a Candidate

Good Candidates for Nexplanon

Nexplanon is one of the most effective contraceptive methods available and is appropriate for a wide range of patients. Dr. Andrei reviews your health history and contraceptive goals at your consultation.

Seeking highly effective, low-maintenance contraception

Women who want set-and-forget contraception without daily, weekly, or monthly action. Greater than 99% effectiveness with no user-dependent compliance required.

Estrogen-sensitive patients or those who cannot use estrogen

Nexplanon contains only progestin — no estrogen. It is appropriate for patients with migraines with aura, certain clotting histories, breastfeeding patients, or others who should avoid estrogen-containing contraceptives.

Teenagers and young adults

Nexplanon is FDA-approved for use in adolescents and is a commonly recommended long-acting option for young patients who want highly effective contraception without daily pill adherence.

Postpartum patients

Nexplanon can be inserted immediately postpartum or at the postpartum visit. It does not affect milk supply and is safe during breastfeeding.

Patients replacing an expiring implant

Removal and same-visit replacement can be performed in a single appointment for patients at the three-year mark. Continuity of contraceptive protection is maintained with no gap.

Patients with difficulty tolerating IUDs

Women who experienced significant discomfort with IUD insertion or who have an anatomical variation that limits IUD candidacy may find Nexplanon a more comfortable long-acting option.

What to Expect

Nexplanon Insertion — Step by Step

Nexplanon insertion at Lapeer Women’s Health takes 5–10 minutes. No hospital, no operating room, no general anesthesia. You can drive yourself and return to normal activity the same day. A bandage and pressure dressing are applied after insertion.

1

Arm Preparation and Positioning

You are seated or lying with your non-dominant arm bent at the elbow, hand near your head. The upper inner arm is cleaned with antiseptic solution and the insertion site is marked.

2

Local Anesthetic

A small amount of local anesthetic is injected just beneath the skin at the insertion site. This causes a brief sting followed by numbness. The rest of the procedure is performed without pain.

3

Implant Insertion

The Nexplanon applicator is positioned at the marked site and the implant is deployed just beneath the skin with a single motion. The applicator is removed, leaving the implant in place. No sutures are required. The entry point is covered with a small bandage.

4

Implant Palpation Confirmation

Dr. Andrei palpates the arm immediately after insertion to confirm the implant is correctly positioned and palpable. You are also invited to palpate the implant yourself for your own confirmation.

5

Pressure Dressing and Aftercare

A pressure bandage is applied over the insertion site and worn for 24 hours. Mild bruising, swelling, and soreness at the site are expected for a few days. The implant becomes effective immediately if inserted on the correct cycle day.

Timing for Immediate Effectiveness
Nexplanon inserted during the first five days of your menstrual cycle is effective immediately. Inserted at other cycle times, a backup contraceptive method is recommended for seven days. Dr. Andrei confirms optimal insertion timing at your appointment based on your current contraceptive use and cycle status.
Before Your Appointment

Common Questions About Nexplanon

The implant is not visible but is palpable — you can feel a small, firm rod beneath the skin. This is normal and confirms correct placement. Most patients report that it is unnoticeable during daily activity. Partners do not typically feel it during intercourse.
Nexplanon inserted within the first five days of your menstrual cycle is effective immediately. If inserted at another point in your cycle, use a backup method for seven days. If transitioning from another hormonal method as directed, protection is continuous with no gap.
The most common side effect is a change in bleeding pattern. Some patients experience infrequent or lighter periods; others experience irregular spotting. Approximately one-third of patients have no periods at all. There is no way to predict individual bleeding patterns in advance. Bleeding changes are not a sign that the implant is not working.
Removal is performed in the office under local anesthetic. A small (2–3mm) incision is made at the tip of the implant, which is grasped with forceps and removed. The incision is closed with a steri-strip or small suture. The entire removal takes approximately 5 minutes. Fertility returns within days.
A non-palpable implant should be evaluated before removal is attempted. Dr. Andrei may order ultrasound or refer for imaging-guided removal if the implant cannot be located by palpation. Removal of a non-palpable implant should not be attempted without imaging guidance.
In-Office
Local Anesthetic Only
MD, PhD, FACOG
Board-Certified Gynecologist
>99% Effective
For Up to 3 Years
Same-Day
Return to Normal Activity
Schedule Your Nexplanon Visit

Three Years of Protection.
Placed in Ten Minutes.

Nexplanon insertion and removal at both Lapeer and Rochester Hills offices — no hospital visit, no general anesthesia. Same-visit removal and replacement available for patients at the end of their implant term.

Lapeer Office
(810) 969-4670
Rochester Hills
(248) 923-3522

The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.

Gynecologic care for women of every age

Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307

Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.