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Bikini incision for hip replacement Vienna | Hip surgery bikini incision
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2. April 2025

Hip re­pla­ce­ment with bi­kini in­cis­ion or con­ven­tio­nal method?

Com­pa­ri­son of hip re­pla­ce­ment with bi­kini in­cis­ion or the con­ven­tio­nal method

Bi­kini in­cis­ion (bi­kini in­cis­ion) or con­ven­tio­nal me­thod? Which tech­ni­que is the bet­ter choice for a hip re­pla­ce­ment? In­ter­view with Priv.-Doz. DDr. Ma­xi­mi­lian Kas­pa­rek MSc

The de­cis­ion to have a hip re­pla­ce­ment is a big step and rai­ses many ques­ti­ons. One of the most im­portant de­cis­i­ons is the choice of sur­gi­cal me­thod. Mo­dern mi­ni­mally in­va­sive tech­ni­ques such as the bi­kini in­cis­ion of­fer pa­ti­ents cos­me­tic be­ne­fits, but the con­ven­tio­nal sur­gi­cal me­thods have also pro­ven their worth. What di­stin­gu­is­hes the two pro­ce­du­res? Which me­thod is the bet­ter choice for which patient? 

To cla­rify these ques­ti­ons, we spoke with Priv.-Doz. DDr. Ma­xi­mi­lian Kas­pa­rek MSc, an ex­pe­ri­en­ced spe­cia­list in the field of hip sur­gery. In the in­ter­view, he ex­plains the ad­van­ta­ges and di­s­ad­van­ta­ges of both me­thods and pro­vi­des va­luable in­sights for pa­ti­ents who are fa­cing a decision. 

Ques­tion: Mr. DDr. Kas­pa­rek, what exactly is the bi­kini in­cis­ion and how does it dif­fer from the con­ven­tio­nal method? 

DDr. Kas­pa­rek: The bi­kini in­cis­ion is a spe­cial in­cis­ion that runs along the na­tu­ral skin ten­sion li­nes in the groin area. It is used in con­junc­tion with the AMIS tech­ni­que (an­te­rior mi­ni­mally in­va­sive sur­gery), which en­ables par­ti­cu­larly gentle im­plan­ta­tion of a hip re­pla­ce­ment. The con­ven­tio­nal me­thod is usually per­for­med with a lon­gi­tu­di­nal incision. 

The main dif­fe­rence is that with the bi­kini in­cis­ion, the scar re­mains cos­me­ti­cally in­con­spi­cuous due to its pla­ce­ment in the groin area. In ad­di­tion, the bi­kini in­cis­ion in con­junc­tion with the AMIS tech­ni­que (an­te­rior mi­ni­mally in­va­sive sur­gery) of­fers the ad­van­tage that the mus­cles are spared, which ac­ce­le­ra­tes he­al­ing and en­su­res op­ti­mal post­ope­ra­tive function. 

Con­ven­tio­nal method

Bi­kini incision

Ques­tion: Which pa­ti­ents par­ti­cu­larly be­ne­fit from the bi­kini incision?

DDr. Kas­pa­rek: Youn­ger, ath­le­ti­cally ac­tive pa­ti­ents, espe­ci­ally wo­men, be­ne­fit cos­me­ti­cally from the me­thod, as the scar re­mains well hid­den in the groin area.

Ho­we­ver, not ever­yone is sui­ta­ble for the bi­kini in­cis­ion. In peo­ple with a com­plex ana­to­mical struc­ture, it may be useful to re­sort to a con­ven­tio­nal method. 

Ques­tion: Are there dif­fe­ren­ces in the du­ra­tion of the operation?

DDr. Kas­pa­rek: The du­ra­tion of the ope­ra­tion is com­pa­ra­ble for both me­thods and is usually bet­ween 60 and 90 mi­nu­tes. Ho­we­ver, the bi­kini in­cis­ion re­qui­res a high de­gree of sur­gi­cal pre­cis­ion be­cause the ac­cess is narrower. 

Ques­tion: Which me­thod of­fers bet­ter pro­sthe­sis stability?

DDr. Kas­pa­rek: Since the bi­kini in­cis­ion, in con­junc­tion with the AMIS tech­ni­que (an­te­rior mi­ni­mally in­va­sive sur­gery), lea­ves the mus­cles int­act, the na­tu­ral joint sta­bi­lity is main­tai­ned. This re­du­ces the risk of dis­lo­ca­tion and al­lows ear­lier weight-bea­ring on the joint. 

Ques­tion: What are the dif­fe­ren­ces in post­ope­ra­tive rehabilitation?

DDr. Kas­pa­rek: One of the big­gest ad­van­ta­ges of the bi­kini in­cis­ion in con­junc­tion with the AMIS tech­ni­que (an­te­rior mi­ni­mally in­va­sive sur­gery) is early mo­bi­liza­tion. Many pa­ti­ents can take their first steps on the day of the ope­ra­tion. Com­plete he­al­ing and re­turn to the usual ever­y­day mo­ve­ment of­ten oc­curs wi­thin 6 weeks.

Ques­tion: What about scar he­al­ing and vi­sual appearance?

DDr. Kas­pa­rek: With the bi­kini in­cis­ion, the scar is about 8–10 cm long and runs trans­ver­sely in the groin crease. As a re­sult, it re­mains vi­sually in­con­spi­cuous and can be con­cea­led by un­der­wear or swimwear. 

For scar care, I re­com­mend spe­cial scar oint­ments, si­li­cone plas­ters and gentle mas­sa­ges to im­prove the ap­pearance. Di­rect sun ex­po­sure should be avo­ided in the first year af­ter the operation. 

Ques­tion: Are there dif­fe­ren­ces in the hip pro­sthe­sis used?

DDr. Kas­pa­rek: No, the hip pro­s­the­ses used are iden­ti­cal, re­gard­less of the me­thod. The choice of im­plants de­pends on the in­di­vi­dual ana­to­mical con­di­ti­ons of the patient. 

Ques­tion: What is the long-term pro­gno­sis for pa­ti­ents who opt for the bi­kini incision?

DDr. Kas­pa­rek: No, the hip pro­s­the­ses used are iden­ti­cal, re­gard­less of the me­thod. The choice of im­plants de­pends on the in­di­vi­dual ana­to­mical con­di­ti­ons of the patient. 

Con­clu­sion: Which me­thod is the bet­ter choice?

DDr. Kas­pa­rek: Both me­thods have their ju­s­ti­fi­ca­tion: The bi­kini in­cis­ion of­fers cos­me­tic ad­van­ta­ges, while the con­ven­tio­nal in­cis­ion is the bet­ter choice in cer­tain ca­ses – for ex­am­ple, in com­plex ana­to­mical conditions.

Each pa­ti­ent is uni­que, so I re­com­mend a de­tailed con­sul­ta­tion to find the best me­thod for each in­di­vi­dual. If you have any ques­ti­ons or would like a con­sul­ta­tion, please do not he­si­tate to cont­act me. 

If you en­joyed this ar­ticle, you might also be in­te­res­ted in other posts from our blog.

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Priv.Doz. DDr.
Maximilian Kasparek, MSc
haelsi Gesundheitszentrum im Achtzehnten Theresiengasse 46/2 1180 Vienna

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