- SPECIALIST ORTHOPAEDIC SURGEON | MELBOURNE, VIC | ALBURY NSW |
- 03 9421 6133
Bikini Incision Total Hip Replacement
A cosmetically discreet surgical option for anterior approach hip replacement
Bikini incision total hip replacement is a refined surgical technique used in combination with the anterior approach to total hip replacement. The procedure is named for the location of the incision, made along the natural skin crease (the “bikini line”) at the front of the hip, which can result in a more discreet and cosmetically appealing scar once healed.
Dr Jason Hockings may recommend this technique for patients who are suitable for anterior hip replacement and would benefit from a minimally invasive incision that blends with the natural contour of the groin crease. This page explains what the bikini incision involves, how it differs from the standard approach, and what you can expect if this option is recommended for you.
Around 2.1 million Australians (1 in 11 people) have osteoarthritis, with a 58% increase expected by 2032 due to population ageing and rising obesity rates
What is bikini incision hip replacement?
The bikini incision is a variation of the anterior approach to hip replacement surgery, where the incision is placed horizontally along the natural skin crease at the front of the hip rather than vertically or obliquely over the thigh.
The surgical steps remain the same; damaged bone and cartilage are removed and replaced with prosthetic components but, the incision location is adjusted to be more concealed. The goal is to perform the hip replacement through a small, cosmetically favourable incision without compromising the effectiveness or safety of the procedure.
Why choose a bikini incision?
For suitable patients, a bikini incision may offer several cosmetic and recovery-related advantages:
- Less visible scarring: The incision lies within a natural crease, making it easier to conceal when wearing swimwear or shorts
- Smaller incision: Typically, 6–8 cm, depending on individual anatomy
- Excellent healing potential: The groin crease area often heals well with minimal tension on the scar
- No compromise on safety or outcomes when performed by a surgeon experienced in the anterior approach
The bikini incision is often preferred by younger, active patients or those seeking a more discreet outcome following hip replacement surgery.
How is it different from a standard anterior incision?
Both techniques use the anterior approach, meaning the hip joint is accessed from the front, between muscles (not through them). The key difference lies in the orientation and position of the incision:
- Standard anterior incision: Typically, a vertical or slightly angled cut along the front or side of the thigh
- Bikini incision: A horizontal incision placed along the natural skin fold of the groin
Both methods aim to preserve muscle, reduce soft tissue trauma, and allow faster recovery but, the bikini incision offers the added advantage of a more discreet scar.
Who is suitable for a bikini incision approach?
Not all patients are candidates for the bikini incision. Dr Hockings will consider several factors when determining your suitability, including:
- Body shape and anatomy
- Skin quality and elasticity
- Soft tissue thickness in the groin area
- Overall health and surgical complexity
In general, patients who are fit and healthy, have lower to average BMI, and are undergoing first-time anterior hip replacement are most likely to be suitable however, Dr Hockings will assess your anatomy during your consultation and imaging review and let you know whether the bikini incision is an appropriate option for you.
How the procedure is performed
The procedure is carried out with the patient lying on their back (supine) using the anterior approach. Dr Hockings:
- Makes a small horizontal incision along the natural groin crease
- Accesses the hip joint through the interval between muscles
- Removes the damaged femoral head and prepares the socket
- Places the new prosthetic components (acetabular cup and femoral stem)
- Uses real-time X-ray guidance to confirm implant position and leg length
- Closes the incision using absorbable sutures or skin adhesive for optimal cosmetic healing
The use of MyHip software and pre-operative planning supports accurate implant placement, tailored to your specific anatomy.
Post-operative care and scarring
As with other minimally invasive approaches, post-operative care includes:
- Early mobilisation with the support of physiotherapists
- Crutches or walking aids in the first 1–2 weeks
- Regular wound care and monitoring during your recovery
- No need for stitches to be removed as absorbable sutures are used
Most patients find that the bikini-line incision fades well over time. Dr Hockings will provide guidance on scar care and sun protection to support the best cosmetic result.
Recovery and cosmetic results
Recovery from bikini incision hip replacement is similar to other anterior approach surgeries. Most patients:
- Are up and walking on the same day or next morning
- Go home within 1–2 days of surgery
- Resume light activity within 2–4 weeks
- Can expect a return to full function over 3–6 months
The main difference lies in the scar’s appearance with many patients report high satisfaction with how discreet the healed incision is, particularly when wearing swimwear or fitted clothing.
During your consultation, Dr Hockings will explain the most appropriate surgical approach based on your condition, anatomy, and individual needs. Many people experience a significant improvement in pain, function, and mobility following hip replacement surgery. Recovery timelines vary depending on the surgical approach and your overall health, but most patients gradually return to walking, driving, and normal activities over the course of several weeks to months.
If you’re living with hip pain or stiffness that’s affecting your quality of life, a thorough assessment can help determine the cause and guide the right treatment path.
