“Hip dips,” scientifically known as trochanteric depressions, are inward curves located on the side of the body, just below the hip bone and above the thigh. These indentations are a normal anatomical feature, occurring due to the underlying skeletal structure. For individuals seeking a smoother, more continuous silhouette, surgical intervention is the most effective method. The procedure that reliably corrects this contour is autologous fat grafting, which uses a person’s own tissue to fill the indentation and create a rounded curve.
Understanding the Anatomy of Hip Dips
Hip dips result directly from the skeletal structure of the pelvis and the positioning of the femur (thigh bone). The indentation occurs where the greater trochanter (bony prominence at the top of the femur) meets the ilium (large bone of the pelvis). This natural space is present in everyone, but its visibility varies significantly.
The prominence of the depression is influenced by factors like hip width, femoral neck length, and fat and muscle distribution. The skin is often tethered to the underlying bone structure at the greater trochanter, pulling the soft tissue inward. This anatomical reality explains why focused exercise, while excellent for muscle tone, cannot eliminate the indentation, as it cannot change the underlying bone shape.
Fat Grafting: The Primary Solution
The standard surgical procedure to correct trochanteric depressions is autologous fat grafting, also called fat transfer. This technique involves harvesting fat from one area of the patient’s body and transferring it to the depressed area on the hip. Using the patient’s own tissue significantly lowers the risk of rejection, offering a natural-looking result.
The process begins with the harvesting phase, where fat is removed from a donor site using low-pressure liposuction. Common donor areas include the abdomen, flanks, or inner thighs, which also provides contouring benefits to those regions. A thin tube, known as a cannula, is used to gently suction out the fat cells.
Next is the purification phase, where the raw aspirate is processed to isolate the most viable fat cells. Techniques involve using a centrifuge to spin the collected material, separating intact fat cells from blood, anesthetic fluid, and damaged cells. This purification is necessary because injecting unpurified material can lead to inflammation or fat necrosis.
The final step is the injection of the purified fat into the trochanteric depression. The surgeon uses a micro-droplet technique, placing small amounts of fat into multiple layers of the subcutaneous tissue. This strategic placement ensures the new fat cells are surrounded by tissue and blood vessels. Establishing a new blood supply is necessary for the fat cells to survive in the new location.
The Surgical Procedure and Recovery
The fat grafting procedure is typically performed on an outpatient basis and can take a few hours to complete. It is commonly done under general anesthesia or local anesthesia combined with sedation, depending on the extent of the transfer and the surgeon’s preference. Patients must arrange for transportation home, as they cannot drive immediately after the procedure.
In the immediate post-operative period, patients experience common side effects such as swelling, bruising, and discomfort at both the donor and injection sites. Swelling and bruising typically fade within two to three weeks. A compression garment must be worn over the treated areas, aiding in healing and minimizing swelling.
The primary post-operative instruction is to avoid placing direct, prolonged pressure on the augmented hip areas for several weeks (typically two to three). Pressure can compromise the survival of the transferred fat cells, a process called revascularization, which is necessary for long-term results. Light activities can usually be resumed within a week, but a full return to strenuous activity takes about six weeks. Final results are visible after up to six months, once residual swelling subsides and the integrated fat cells stabilize.
Alternative Approaches and Patient Suitability
While autologous fat transfer is the most common surgical correction, other options exist. Solid silicone hip implants provide a guaranteed, permanent volume increase, particularly for individuals who lack sufficient harvestable fat for grafting. These implants are custom-molded and designed to feel like natural muscle tissue.
Non-surgical approaches are also available, primarily using injectable dermal fillers. Sculptra, a poly-L-lactic acid injectable, is often used off-label as a collagen stimulator to gradually add volume. The main limitation of fillers is their temporary nature; results last up to two years before a touch-up is needed, and the cost can be high due to the large volume required.
Patient suitability for fat grafting depends on several factors, primarily the presence of sufficient healthy fat stores. Candidates must be in good overall health with no medical conditions that could complicate surgery or recovery. Maintaining a stable weight is important, as significant weight fluctuations can affect the volume of the transferred fat. Patients must have realistic expectations, understanding that a portion of the transferred fat (often 30 to 50 percent) may be reabsorbed by the body.