Successful removal of an impalpable LARC implant

When a patient presents for removal of an impalpable contraceptive implant, what is the best course of action?

Stephanie is a 31-year-old retail worker who presents as a new patient requesting removal of her etonogestrel contraceptive implant.

She reports that this is her third implant, which was inserted nine months ago.

Stephanie now wants it removed as she wants to try to conceive. She also mentions that this implant has felt uncomfortable and “weird” since insertion.

Stephanie is a nulligravida who has never smoked, drinks no alcohol and is not on any regular medication apart from prenatal vitamin supplements.

Her previous implants were all inserted in the left arm and each left in situ for three years.

When asked if she can feel the implant, Stephanie replies “not always”.

She is unable to locate it at today’s review. The GP also attempts to palpate the implant but cannot locate it.

Stephanie is referred for an X-ray of the left