The Bikini Hip Replacement or “Bikini Incision” Hip Replacement:

Bikini hip replacement is a variation on the Anterior Approach for hip replacement. The skin incision is made within the skin fold of the “bikini line” or frontal groin crease.  Therefore, the resultant surgical scar is aesthetically hidden when wearing underwear or swimwear (e.g. a bikini).

The only difference between the bikini hip replacement surgical technique and the traditional anterior approach is the orientation of the skin incision. Below the skin layer, Mr Freedman performs the operation in exactly the same way as for other anterior approach hip replacement.

In the traditional Anterior Approach technique, the incision is already short and neat is usually 6-8cm in length. The incision  runs obliquely on the front of the thigh. The small resultant scar fades to a thin white line. The scar may potentially be visible just below the bottom seam of underwear or swimwear. Patients tolerate this very well.  The bikini hip incision technique orientates the skin incision in the groin crease. As a result there is “no visible scar”, which may be relevant for young women or other patients for whom the cosmetic aspect of the scar is a priority.

Dr Frederic Laude (Orthopaedic Surgeon, Paris) developed the the bikini incision surgical technique. Dr Michael Leunig (Orthopaedic Surgeon, Switzerland) further popularised this technique. Mr Freedman has travelled to Switzerland and France to be trained in this technique. Mr Freedman utilises this surgical approach in appropriate circumstances. 

Patient Selection:

Mr Freedman does not advocate this approach for all anterior hip replacement patients.
The orientation of the incision can limit surgical exposure in certain body shapes and may not be ideal for all patients. In hip replacement, accurate positioning of the prosthesis is more important than where the scar is positioned.

At your consultation Mr Freedman will advise you of the pros and cons of various surgical options. Mr Freedman will be able to to recommend the most appropriate management for your hip problem.

If you are interested in learning more about the bikini incision for hip replacement please contact our rooms: Tel (03) 9532 3333.

Frequently Asked Questions (FAQ) regarding Anterior and Bikini Incision Hip Replacement:

Q:  I am quite a large patient – am I still able to have a bikini/anterior hip replacement?

A:  The anterior approach for hip replacement is possible for most body shapes. Shape and body weight alone is usually not a determining factor as to what surgical approach is preferred. Mr Freedman may, however, not advise a bikini incision for all patients.Mr Freedman may advise against an anterior approach if you have a particularly large abdomen (tummy) that hangs well down over the front of your  thigh. Surgical access may be difficult. Also, a large apron of skin at the front of the thigh may pose an infection risk for surgery through the anterior approach. Mr Freedman endeavours to offer the anterior approach for most patients but will have an honest conversation with you if a different approach is preferred. For larger patient Mr Freedman may suggest to place the surgical incision away from the groin crease rather than within the groin crease.

Mr Freedman is trained in and performs all contemporary hip approaches and so will be able to advise as to the safest and most appropriate technique for your surgery.

Q: I’ve seen another surgeon for an opinion. I was told that the anterior approach is new and unproven. What do you say to that?

A: Mr Freedman completely disagrees and feels that this view is grossly misinformed.
The anterior approach is relatively new to Australia but has been  firmly established in France, Switzerland and elsewhere in Europe for many years.
If you were having a hip replacement in Paris (or Geneva or elsewhere in Europe) the surgeon would most likely use the anterior approach.  The anterior approach has also rapidly gained in popularity in the United States in recent years.
It would be correct to say that most surgeons in Australia are untrained in and unfamiliar with the anterior approach. Mr Freedman consequently sought out specialised training in France and Switzerland to be able to offer this surgery to patients in Melbourne.

Q: Is there a risk of nerve damage from the Bikini Hip Replacement?

A: No. There is a small nerve which runs in the front of the thigh which the surgeon needs to protect during anterior hip replacement surgery (lateral femoral cutaneous nerve). So long as the surgeon is appropriately skilled, there is no difference in complications between the standard and bikini incision techniques. See reference papers below.

Q: What pain medication will I need to take after Bikini Hip Replacement?

A: Not very much at all. We utilise an “Enhanced Recovery” programme to help you recover and rehabilitate quickly after surgery.
With this programme most patients will not need to take strong pain killer tablets.  Most patients will receive a special pain patch which is worn on the skin for a few days and will only need to take the odd tablet for any breakthrough pain. More information on the Enhanced Recovery Programme (ERAS)  can be found on the dedicated section on ERAS on this website.

References for Bikini Hip Replacement: 

  • Skin crease ‘bikini’ incision for anterior approach total hip arthroplasty: surgical technique and preliminary results. Clin Orthop Relat Res. 2013 Jul;471(7):2245-52.  Leunig M, Faas M, von Knoch F, Naal FD.
  • Bikini versus traditional incision direct anterior approach: is there any difference in soft tissue damage?Hip Int. 2017 Jul 25;27(4):397-400.  Lanting BA, Hartley KC, Raffoul AJ, Burkhart TA, Sommerville L, Martin GR, Howard JL, Johnson M.

 

For more information on anterior hip replacement or  “bikini hip replacement”  please contact our office to schedule an appointment.  Tel (03) 9532 3333.