Subdermally Placed Implanon Migration Into the Pectoralis Muscle and Its Removal in a Resource-Limited Setup: A Case...

Due to their effectiveness, convenience, and reversibility, single-rod etonogestrel devices such as Implanon and Nexplanon are increasingly popular as long-acting reversible contraceptive methods. Despite these benefits, rare but serious side effects such as device migration can occur, making diagnosis and surgical removal challenging. We report a case of a 40-year-old woman who presented with an irretrievable contraceptive implant, despite multiple unsuccessful blind surgical attempts at nearby health centers. The device, originally inserted in her left arm 6 years ago, was localized through sequential ultrasound, X-ray, and targeted high-resolution ultrasound imaging, which identified the implant in the left pectoralis muscle. Ultimately, ultrasound-guided removal was successfully performed by a multidisciplinary team. This case highlights the importance of image-guided techniques for safe and effective implant retrieval, rather than relying on blind surgical exploration.