A Family Physician's Experience in the Removal of Migrating Subdermal Contraceptive Implants

Subdermal contraceptive implants are among the most effective and reversible contraceptive methods available today. Implanon®️, approved by the US FDA, is widely used for long-term family planning due to its extended contraceptive effects. Although generally safe, these implants can occasionally lead to rare but serious complications, such as migration into deeper axillary structures. In this case report, we describe the experience of a family physician with a 30-year-old Saudi woman whose Implanon implant migrated approximately 11 cm from the original insertion site over three years. The patient presented for removal of the implant, which had reached the end of its contraceptive duration and was to be removed in preparation for future conception. Initial attempts by the family physician to localize and remove the implant were unsuccessful due to its continued migration toward the axilla. Consequently, the case was referred to the obstetrics and gynecology clinic and subsequently to the orthopedic department. The foreign body was successfully removed using an intraoperative, fluoroscopy-guided procedure, with no complications observed post-surgery. This case underscores the importance of physician awareness and a multidisciplinary approach to managing such complications. It also highlights that implant migration is not necessarily related to the physician's skill or patient characteristics, underscoring the unpredictable nature of this complication. This report aims to provide insights and recommendations for handling similar cases, advocating for early intervention, and the use of imaging techniques when managing non-palpable implants.