Deep/Impalpable Contraceptive Implants

Referral Criteria for the Management of Deep or Impalpable Contraceptive Implants

Women presenting for removal of a contraceptive implant where the device is impalpable, deep enough to cause concern that standard removal will not be possible, or where there have been previous attempts at removal.

If the implant is impalpable please consider pregnancy testing, advise use of additional contraceptive precautions and arrange x-ray of the arm (for Nexplanon) or ultrasound to determine if the device is present. If the device is not seen on x-ray a CXR is also recommended in case of intravascular migration.

Please refer patients with deep or difficult to remove implants to:


 Dr Dianna Sells

 Community Contraception and Sexual Health

 Cumberland Centre

 Damerel Close

 Plymouth, Devon PL1 4JZ


Information to Include when referring:


Duration of use

Where and by whom it was fitted

Results of any x rays or scans



Faculty of Sexual and Reproductive Healthcare Clinical Guidance. Progestogen Only

Implants February 2014


Date Reviewed                                    08/01/2020

Date of Next Review                          08/01/2021

Authors                                               Dr Frances Fuller, Associated specialist in Sexual Health, the Hub, RCHT

                   Dr Issy Boyd, RMS GP sifter


Version No.  3.2