Placement of Implanon NXT at alternative sites

Statement of the Clinical Reference Group of the FPAA Medical Advisory Committee

Family Planning Organisations are occasionally asked about whether Implanon NXT can be inserted at a site other than the non-dominant upper inner arm. A comprehensive literature search has failed to find any evidence to support alternative site placement of the implant. The risks of alternative placement include a potential for deep placement and difficult removal, implant migration, implant breakage and the risk of injury to surrounding neurovascular structures. Expert opinion lends cautious support to placement at an alternative site in the rare case where the benefits may outweigh any potential risks. An understanding of local anatomy at the proposed placement site is imperative before insertion and removal. While a differential effect on contraceptive efficacy, side-effects and risks is unlikely, there is no guarantee that efficacy will be the same as for standard placement. The patient must be made aware that the placement is ‘off label’ with thorough documentation to this effect.

See Implanon NXT alternative site placement for full details.

Note: The Medical Advisory Committee of Family Planning Alliance Australia is comprised of senior medical educators, senior medical officers, and medical directors of the member family planning organisations. The Clinical Reference Group of the Medical Advisory Committee exists as a means to review current clinical practice and provide evidence and consensus-based recommendations for use by clinicians where clinical guidance is lacking.