Removal of a migrated subdermal contraceptive implant: a case report and review of the literature

The contraceptive implant Implanon-NXT® provides long-acting, highly effective, and reversible contraception. Migration and embolization of the implant are rare but can cause potentially serious complications. We describe the case of a migrated Implanon-NXT® implant in a 35-year-old woman who requested extraction due to abnormal uterine bleeding and pain in the arm carrying the implant. The device was neither palpable at the insertion site, nor was it localized by ultrasound. Radiographic examination and Computed Tomography (CT) scan revealed it had migrated to the axilla and was in close proximity to neurovascular structures. Extraction was performed under general anesthetic and radiographic guidance.