For some patients, removal of Long-Acting Reversible Contraceptives (LARCs) is complicated because the implant has moved or can’t be felt by hand.
Regional One Health is now the only west Tennessee Center of Experience for Contraceptive Implant Removal.
By providing this additional level of expertise, our team can help patients have implants removed safely so they can meet their family planning goals.
For many patients, LARCs – Long-Acting Reversible Contraceptives – are an effective, safe, and convenient method of birth control.
LARCs, which include IUDs and implants like Nexplanon, have the highest success rate of all reversible birth control options at over 99 percent effective. Patients don’t have to remember to take a daily pill, and they offer long-term protection while still being reversible if a patient decides they want to conceive.
However, some patients with the Nexplanon implant do encounter difficulty with removal. That’s where Regional One Health’s additional expertise can help: the hospital was recently recognized by the Society of Family Planning as a Center of Experience for Contraceptive Implant Removal. Regional One Health is the only Center of Experience in west Tennessee.
Molly Houser, MD and Linda Moses, MD provide contraceptive implant removal in Regional One Health’s Complex Contraception Clinic, which they developed to help patients who require specialized birth control counseling and care.
“For most patients, removal is very simple,” Dr. Houser said. “Usually, the implant is right under the skin, and we can feel it. We just numb the area over the implant, make a tiny incision, and remove the implant.”
However, some patients experience what is described as deep or non-palpable implants. The implant can’t be felt by hand or has migrated to a location that makes removal more difficult. “Some of these patients have had multiple attempts at removal, and they end up with scarring,” Dr. Houser noted.
As a Center of Experience, Dr. Houser and Dr. Moses offer the additional training, expertise, and resources patients need for safe implant removal.
They start by using ultrasound, X-ray, CT, or MRI imaging to visualize the implant.
“It is important for patients to have options and access for having their devices removed when they want them removed, because that gives them the most reproductive autonomy,” says Dr. Molly Houser.
Often, they can remove it immediately right in the clinic using ultrasound guidance. If the implant is deep or is near nerves or blood vessels, they can coordinate with interventional radiology or general surgery to schedule the removal. In either case, removal is an outpatient procedure, meaning the patient goes home the same day.
Dr. Houser added she and Dr. Moses will also be training University of Tennessee Health Science Center OB/GYN residents and additional Regional One Health providers to perform these procedures, so there are more providers available in the community in the long-term. She said the goal is to improve access to care that meets their patients’ family planning goals.
If a patient has an implant and wishes to become pregnant, removal is essential – an implant is FDA approved for three years of protection against pregnancy, but many studies show they are still 99 percent effective or higher at preventing conception up to five years.
“It is important for patients to have options and access for having their devices removed when they want them removed, because that gives them the most reproductive autonomy,” Dr. Houser said.
She said patients can self-refer to the Complex Contraceptive Clinic or ask their primary care or OB/GYN provider for a referral. Patients can visit www.SocietyFP.org to learn more about Centers of Experience.