Apex suddenly flared up painfully around ~10 days post install

Hi all,

I recently got my Apex Flex installed professionally with a needle install, into the middle of my forearm on my left hand. The installer has been recommended here before, I don’t think they did anything wrong.

It was sore as you’d expect, but healing up well, the wound closed up within a few days. There was a bit of swelling and tenderness as you’d expect.

I’ve been doing my best to be gentle with the arm, backing off when it’s sore.

When moving the arm the ‘wrong’ way it’d be a bit sharply painful but the swelling and bruising had generally been going down. It felt like the chip was just settling, my xSIID would jiggle things slightly quite often so at first I wasn’t hugely concerned.

Today it has suddenly ballooned up in size, feeling hot to the touch and painful enough to make me feel faint. The pain reduces with elevation or moving it to the right angles, moving the hand gently also seems to ‘loosen’ it off a bit.

I went to the local ER as soon as it felt a bit swollen and angry, and they gave me some Flucloxacillin and said they weren’t sure if it was infected, but wanted to be on the safe side.

It went down over the few hours after that, and the pain abated in a big way. The redness and swelling had dropped massively too. But after a nap, it has come back again with the feeling of tightness under the skin.

To me, without being a professional, it feels more ‘achey’ than when I’ve had bad infections in the past. I wonder if it’s irritating the radial nerve.

Picture attached of it when it suddenly flared up earlier today. It went down from that but has come back up again to looking broadly similar.

this is what I am seeing

Am I alone?

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Same, @Ghosts needs to reupload the pic.


Fixed the image, browser issue. Thanks.

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No, surprises, It looks like an infection and antibiotics is probably the best treatment at the moment.
Your body seems to be reacting well.
I would suggest you draw an outline around the area, and monitor if it is increasing or decreasing in size.

Also, just guessing, but there is a slightly more open part of the scar, I wonder if that was a path for the infection :man_shrugging:

To me ( not a doctor ), it seems like you are doing the right things, just keep an eye on it, and update this post with progress, and we can help you keep an eye on it, and provide advice/ suggestions ( for what its worth )


Hmm if it’s hot, red, or raised then definitely need to consider possible infection. Perhaps a longer regimen of antibiotics is necessary? Definitely consult with your regular doctor not just ER docs who can’t help beyond the immediate treatment.

An update:

I’ve been put on stronger antibiotics as they expected at least it not getting worse overnight.

Now on coamoxiclav and also have Fucidin cream for it.

Consensus seems to be poor luck, am I right in thinking rejection would usually be more aggressive?

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Rejection is not infection… rejection is the result of a successful campaign by bacteria to infect and totally fuck up your body in the area of the implant. Rejection is the result… the implant comes out because your body is trying to dump everything to save itself. The infection is the problem.


A few hours after the first dose of the Fucidin and the Amoxiclav and the swelling has gone down significantly, as has the heat in it.

There is that large bump, which I’m hoping doesn’t contain an escaping Apex.

Is there much I can do now beyond rest, keeping the arm immobile and the antibiotics?

Difficult to tell in the photo, but in my opinion, IF the bump IS the Flex, and the edge of it is trying to slice its way out, you may be fighting a losing battle.

This NORMALLY only happens when the pocket that is made is not deep enough, and as it heals, the body tries to push the implant “foreign body” out.

So you may have 2 issues
Infection AND rejection.

If it were me, ( not a reccomendation, you’re a big boy and can make your own decisions ) I would be trying to see if I could push the implant further into the pocket, if the pocket was long enough.
I would tape down a barrier ( eg. a chuppa chup stick ) between the front edge of the flex and the entry site. ( keeping the area as clean as possible obviously )
I would ensure to finish the course of antibiotics.
IF the apex is knocking on the door of the entry site and won’t slide back, You maybe better off removing it, re-sterilize it / get it re-sterilized and try again.

Did you happen to video or photograph the procedure?
Was it done with the custom needle or a scalpel?
How was the Flex pushed in? any tools? Gloved finger?

The questions above are Not a witch hunt, just trying to figure out the reasons for the Infection AND rejection, as this is not a typical experience.


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I don’t want to poke at it really for obvious reasons.

It feels like the implant is sat well below the hole though and not protruding last I checked.

It was a flex needle installed by an installer recommended here, they’re really good and I’ve had good experiences in the past with them.

When I’m applying the next lot of antibiotic cream with clean hands, I’ll see if I can figure out the position it’s sat in without upsetting it too much.

I’m maybe too worried or stupidly optimistic that it’ll settle down. But I can’t quite figure out which.

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Ah, good, when I read this

I imagined that your Apex was Turtling


Pocket of pus? There’s already a cavity there so it makes sense for the infection fluids to build up in there :thinking:

Great band name

:drum: :guitar:

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If your doctor is not freaking out over the implant, this might be the perfect reason to get an x-ray? Just to see if it’s staying put.


If the flex needle was used, and we assume they inserted the needle to the depth marker and placed the flex… then we can assume the flex has a deep enough pocket and is resting comfortably in it.

The bump may be a skin flap that was not properly pulled back out on needle removal. This has to do with the bevel up vs bevel down installation discussion where if the bevel is up when the needle is inserted, a small skin flap will be made from the needle’s insertion. That skin flap gets folded under inside the wound and if the removal of the needle does not pull the flap back out, it will get stuck under / inside the wound. This could be the source of the infection as well since most skin prep is not deeply penetrating. As the skin inside the wound breaks down, latent bacteria in deeper layers can escape into the wound and flourish.


I’m keeping this updated because it’s an interesting documentation of the process.

The same day as starting the new antibiotics it has started draining nicely.

A warm compress over a sterile dressing seemed to really help draw it out. (I didn’t want anything unclean coming into contact with it)

I put a fresh dressing over it overnight and that has caught plenty of ick too. Now it’s draining consistently as I move around, which is dropping the pain level.

I also slept much better, and feel much better in myself.


The updates are appreciated!

Lots of pus still draining. I’m feeling much better in myself, which suggests to me that my body doesn’t feel it’s having to fight as hard.

Using the arm to type etc is now doable, and the movement seems to be helping more pus keep coming out.

The holes the pus is leaving through are tiny, and moving the arm in ways that is painful helps push more out too.

The compress to open it up with the dressing seems to have really been the key. I’m changing the dressing regularly as it seems to be helping draw more ick out.

Hopefully I’m on the mend.


As the day went on yesterday, the discharge became clearer, more like serous fluid, which felt like progress.

Though by last night I’d used the arm too much during the day and it looked quite red and upset, almost like a sunburn.

After sleep, the redness and swelling has gone down to the smallest it has been. The warm area has also shrunk. It has also pushed out lots more pus into the dressing.

This is day 3 of amoxiclav and fucidin cream and they seem to be really working.