Why Is There a Dent in My Hip? Causes Explained

A visible dent or indentation on the hip usually comes down to one of two broad categories: it is either a normal feature of your skeletal and soft-tissue anatomy, or it is a localized change in fat or muscle beneath the skin caused by injury, medical procedures, aging, or an underlying condition. The most common version, often called “hip dips” or “violin hips,” is simply the natural inward curve between the top of your pelvis and the upper thigh, visible in millions of people who have nothing medically wrong. But dents that appear suddenly, feel painful, or show up on only one side can point to something worth investigating.

The Anatomy Behind “Hip Dips”

The outer contour of your hip is not shaped by a single structure. It is a layered sandwich of bone, muscle, and fat, and each layer contributes to the surface shape you see in the mirror. At the top sits the iliac crest, the bony rim you can feel along the top of your pelvis. Below that, the greater trochanter of the femur juts outward at the upper thigh. Between those two bony landmarks, there is a gap where no bone pushes outward. The gluteus medius and tensor fasciae latae muscles span that gap, and a variable layer of subcutaneous fat sits on top. If the muscles are relatively thin and the fat layer is modest, the skin follows the underlying skeleton inward, creating that characteristic dip or dent.

This is why hip dips tend to be more or less visible depending on your bone structure, muscle mass, and how your body distributes fat. People with wider-set hip bones or a greater distance between the iliac crest and the trochanter are more likely to have a noticeable inward curve. None of this is a defect or disorder. It is geometry.

How Fat Distribution Creates (or Hides) Hip Contours

Where your body stores fat around the hip is not random. Research on subcutaneous fat thickness around the hip joint has found that the ratio of fat deposited on different sides of the hip varies significantly between men and women, and that the relationship between body mass index and fat thickness in the lateral hip region also differs by sex and age group.

In plain terms, women tend to carry more fat on the outer hip than men do, and older men distribute fat differently than younger men or women of any age. These patterns help explain why hip dips are more visible in some people than others, and why the same person’s hip contour can change over the years. Hormonal shifts during puberty, pregnancy, and menopause all redirect fat storage. A review of body fat distribution research confirms that sex hormones and aging are major drivers of where fat accumulates, though the genetic mechanisms behind these patterns remain only partly understood.

So if you notice your hip dips becoming more or less prominent over time, it may simply reflect a shift in how your body is allocating fat, driven by hormones, aging, or changes in weight. This is not a sign of disease. It is your body doing what bodies do.

Muscle Atrophy and the Gluteal Shelf

If the dent in your hip appeared gradually and you are middle-aged or older, muscle wasting in the gluteal region is worth considering. The gluteus medius and gluteus minimus are the two muscles most responsible for filling out the lateral hip contour. When they shrink, the surface of the hip loses volume and the underlying bone becomes more visible, creating a dent or hollow appearance.

An MRI-based study of older individuals found a strong positive relationship between advancing age and both tendon disease and muscle atrophy in the gluteus medius and gluteus minimus. The association was moderate to strong, and the pattern was clear: older participants had more tendon pathology and more muscle wasting in these specific muscles. Interestingly, the same study found only a weak association between age and wasting of the tensor fasciae latae, and no significant age-related atrophy in the iliopsoas, suggesting the problem is relatively selective to the gluteal muscles that shape the outer hip.

This kind of atrophy does not always cause pain. You might just notice that your hip looks flatter or more indented than it used to, or that your trousers fit differently. But when it is accompanied by lateral hip pain, difficulty walking, or a limp, it could indicate a torn or degenerating gluteal tendon. A clinical test called the Hip Drop Test has been developed to help screen for abductor tears. In one evaluation, the test showed a sensitivity of about 88% and a specificity of about 87% for diagnosing hip abductor tears, with a very high negative predictive value, meaning a negative result is quite reliable for ruling out a tear.

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If your hip dent comes with weakness or pain when you try to stand on one leg or walk up stairs, that combination is worth bringing up with a doctor. Imaging can then distinguish between simple age-related muscle loss and a structural tendon problem that might benefit from physical therapy or, in severe cases, surgical repair.

Trauma, Falls, and Localized Fat Loss

A dent that appears after an injury has a different explanation. When the subcutaneous fat layer around the hip takes a hard hit, the damaged fat cells can die off in a process called fat necrosis. Over time, the dead tissue either breaks down and is absorbed or is replaced by scar tissue, leaving a permanent depression in the skin’s surface. A case report on posttraumatic fat necrosis of the posterior pelvis described how blunt trauma led to subcutaneous fat defects, with MRI imaging revealing scar tissue running through the damaged area. The authors noted that this kind of fat atrophy can follow falls, blunt injury, surgery, and even minor procedures or injections.

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The hip is especially vulnerable to this because it is a common impact site during falls, bike accidents, and contact sports. The greater trochanter sits right under a relatively thin layer of soft tissue in many people, so a direct blow can compress fat against bone with enough force to destroy fat cells locally. The resulting dent can take weeks or months to become fully visible, because the body needs time to clear the damaged tissue. Some people also develop a palpable lump or chronic tenderness in the area, which can be confusing if the original injury seemed minor.

Injection-Related Dents

If you have had corticosteroid injections in or near the hip, the dent may be a side effect called local tissue atrophy. Corticosteroids are powerful anti-inflammatory drugs, and when injected into a joint or bursa near the hip, some of the medication can migrate into surrounding fat tissue and cause it to break down. The result is a visible depression at or near the injection site.

A review of complications from corticosteroid injections assessed by medical expert commissions confirmed that tissue atrophy is a recognized risk, and recommended that patients be informed of this possibility before receiving injections.

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The atrophy can be temporary or permanent, depending on how much fat was affected and how deeply the injection was placed. In some cases, the dent fills back in over several months as the steroid is fully metabolized and fat cells regenerate. In others, the loss is lasting.

This is not limited to hip-specific injections. Intramuscular injections in the gluteal region for other medications can occasionally produce a similar effect, though it is far less common with non-steroidal drugs. If you have a dent that lines up with a previous injection site, this is the most likely explanation.

Dermatological and Lipodystrophy Conditions

Less commonly, a hip dent can be caused by a condition that attacks the fat layer itself. Localized lipodystrophy is a group of disorders in which subcutaneous fat breaks down or fails to develop in specific areas. These can occur on their own or alongside autoimmune conditions, and they sometimes mimic or overlap with a skin-hardening condition called morphea.

In one documented case, a patient developed what initially looked like a morphea lesion but turned out to be localized involutional lipoatrophy. Biopsy of the affected tissue showed non-inflammatory changes in the fat layer, with smaller-than-normal fat cells and widened connective tissue bands between fat lobules.

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The key feature of these conditions is that the overlying skin may look normal or only slightly different, while the fat underneath has quietly disappeared. The dent is soft, painless, and clearly defined, with sharp borders that distinguish it from the gradual contour changes of normal aging or weight loss.

Lipodystrophy conditions are uncommon enough that most people with a hip dent do not have one. But if the dent appeared without any trauma, injection, or weight change, and especially if the skin over it looks discolored or feels unusually firm, a dermatologist can take a biopsy to check for these rarer causes.

Post-Surgical Contour Irregularities

Hip dents can also follow surgery in the area. Hip replacement surgery, for example, involves cutting through layers of muscle and fat to reach the joint, and the healing process does not always restore the original surface contour perfectly. Liposuction of the hips or flanks is another common culprit. When fat is removed unevenly, or when the skin does not retract smoothly over the remaining tissue, the result can be a visible dent, ridge, or asymmetry. A review of liposuction outcomes emphasizes that the procedure is fundamentally a body-contouring technique with inherent limitations, and that contour irregularities are among the recognized unfavorable results.

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People who have had liposuction and later gain or lose weight sometimes find that the treated area gains fat differently from the rest of the body, creating a mismatch in contour that shows up as a dent or bulge. If you had any surgical procedure near the hip and a dent developed afterward, the connection is straightforward even if it took months for the final contour to settle.

When a Hip Dent Deserves Medical Attention

Most hip dents are cosmetic, not medical. The “hip dip” that is simply your anatomy, the age-related softening of the lateral hip, or the shallow mark left by an old injection are all things you can live with comfortably. But a few patterns warrant a closer look:

Sudden onset: A dent that appears over days to weeks without trauma or injection could suggest an underlying soft-tissue process like lipodystrophy or, rarely, a deep soft-tissue infection.
Pain with movement: A visible dent paired with difficulty standing on one leg, climbing stairs, or walking without a limp may indicate gluteal tendon damage. The screening test described earlier, the Hip Drop Test, can help your doctor decide whether imaging is needed.
Skin changes: Discoloration, firmness, or thickening of the skin over the dent points toward a dermatological condition rather than simple fat or muscle loss.
Growing lump nearby: Posttraumatic fat necrosis sometimes presents as a mass next to or beneath the dent. While usually benign, any new lump in the soft tissue should be evaluated to rule out other causes.

For straightforward cases, your primary care doctor can assess the area with a physical exam and a brief history. More complex situations, particularly those involving pain, progressive changes, or suspected tendon tears, usually call for an MRI, which can distinguish between muscle atrophy, tendon pathology, fat necrosis, and other soft-tissue changes with good accuracy.

Cosmetic Approaches for Hip Dents

For people whose hip dent is purely a cosmetic concern, the options range from exercise to surgery, and the right choice depends entirely on what is causing the dent in the first place.

If the dent is a hip dip caused by your skeletal anatomy and modest soft-tissue coverage, targeted strength training of the gluteus medius can add muscle volume in the depression zone. Exercises like side-lying hip abductions, banded clamshells, and single-leg deadlifts specifically recruit the muscles that fill that area. The results are incremental and depend on your starting anatomy, but many people find that a few months of consistent work softens the contour noticeably.

When exercise is not enough, or when the dent results from fat loss or surgical irregularity, fat grafting is a surgical option. A study on gluteal augmentation found that selective autologous fat grafting was particularly useful in patients who had pre-existing contour irregularities, including deformities from earlier procedures.

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In this technique, fat is harvested from another area of the body and injected into the depression to restore volume. The tradeoff is that some of the transferred fat is reabsorbed over time, so the initial correction may shrink. Dermal fillers are occasionally used off-label for smaller dents, though their effect is temporary and the cost adds up with repeated treatments.

For dents caused by injection-related atrophy, time alone sometimes resolves the problem. In other cases, a cosmetic surgeon can inject a small amount of fat or filler to restore the contour. And for post-liposuction irregularities, revision liposuction or fat grafting can smooth out the surface, though the results depend heavily on skin quality and the extent of the original problem.

How Clothing and Lighting Play Tricks

It is worth acknowledging that hip dents often look more dramatic than they actually are, depending on what you are wearing and how the light hits your body. Tight athletic wear, particularly leggings or compression shorts with a high waistband, can press into the top of the hip at the iliac crest and push the softer tissue below inward, exaggerating the dip. Stand in the same spot wearing loose shorts and the dent may all but disappear.

Overhead or side lighting casts shadows that emphasize every surface contour, and this is exactly the lighting in most gym mirrors and bathroom setups. The same hip viewed under diffuse, front-facing light looks substantially smoother. This optical effect accounts for a lot of the anxiety people feel when they notice a hip dent for the first time. Chances are it has been there for years and a change in clothing or lighting simply made it newly visible.

If you are comparing your hips to images you see online, keep in mind that posing, camera angle, and editing all flatten lateral contours in ways that make hip dips invisible. Nearly everyone has some degree of inward curve at the lateral hip when standing relaxed in neutral lighting. It is one of the most common and least talked-about features of normal human anatomy.