Written by: Dr. Akash Chandawarkar, Board Certified Plastic Surgeon, Mirror Plastic Surgery | Last updated: September 9, 2026
Key Takeaways
- Hip dips come from skeletal anatomy, specifically the gap between the ilium and greater trochanter, and this structure is largely genetic.
- Fat distribution patterns that affect how visible hip dips look are also heritable, but they do not change the underlying bone.
- Exercise cannot remove hip dips because muscle growth does not alter bone structure, and training can sometimes make dips look deeper.
- Age-related muscle loss, hormonal shifts, and weight changes can make hip dips more noticeable over time, especially after age 65.
- Mirror Plastic Surgery offers non-surgical biostimulatory filler treatments for hip dips; book a consultation to review your anatomy and options.
The Anatomical Foundation: How Bone Structure Creates The Dip
The Ilium, Femur, And Greater Trochanter
Hip dips form where the upper pelvis and upper femur do not fully meet. The indentation sits between the iliac crest, the upper wing of the pelvis, and the greater trochanter, the bony bump at the top of the femur. Cleveland Clinic exercise physiologist Katie Lawton explains that hip dips are a natural indentation caused by the femur’s angle and the greater trochanter’s position relative to the pelvis, and that their visibility varies based on individual bone structure.
What Research Shows About Skeletal Variation
The depth of a hip dip depends on pelvic width, femoral neck length, and the size and position of the greater trochanter. Pelvic width and femoral neck length are strongly genetically determined, with heritability estimates of about 32–48% for pelvic proportions and 0.28–0.70 for proximal femoral geometry, although environmental factors still play a role.
Cleveland Clinic notes that hip dips are “very” common and that everybody with typical anatomy has them, with variation only in how much they show. Hip dips are a universal anatomical feature in people with typical anatomy, and visibility is what changes from person to person.
The Genetic Evidence: How Fat Distribution Changes Visibility
Fat Distribution Is Independently Heritable
Subcutaneous fat distribution strongly influences how sharply a hip dip appears over the bony gap. When fat collects above and below the dip but remains thin directly over the trochanteric depression, the indentation looks deeper.
This fat patterning is partly genetic. A 2017 genome-wide meta-analysis by Graff et al. (PMID 28448500) of 241,258 adults identified novel loci for obesity traits, including BMI and central adiposity. The same study found that tobacco smoking may alter genetic susceptibility to overall adiposity and body fat distribution.
Sex Differences In Fat Patterning
A landmark study by Heid et al. (2010) found that loci associated with waist-to-hip ratio adjusted for BMI influence body fat distribution independent of overall adiposity, with seven loci showing stronger effects in women than in men. Premenopausal women usually carry more gluteofemoral fat than men, who accumulate more visceral fat, due to sex hormones and genetic factors, but postmenopausal women tend to gain more abdominal fat.
Two people with the same weight and fitness level can have very different hip dip visibility because their inherited fat distribution patterns differ.
The Exercise Question: What Training Can And Cannot Change
The Muscle–Bone Disconnect
Targeted exercises such as side-lying leg raises work the gluteus medius and minimus, the muscles often trained to “fill in” hip dips. Evidence supports their role in strength and function, not in changing bone-driven contours.
The National Strength and Conditioning Association (NSCA) notes that exercise can change muscle mass and shape but cannot change an individual’s skeletal structure.
When Training Makes Dips Look Deeper
Multiple experts report that building muscle and losing fat around the hips can make hip dips more visible. Adam Taylor explains that as muscle develops and fat thins, “the underlying bones and muscles can become more prominent, potentially making the dip more visible rather than less.”
The Overuse Risk
Intense, repetitive hip-focused workouts can also create overuse injuries. Overloading the gluteus medius through repetitive exercise is a leading cause of microtrauma that can trigger greater trochanteric pain syndrome, which is about four times more common in women and affects roughly 20–25% of the general population at some point and 15–35% of people over 50.
Exercise improves strength and overall gluteal contour, yet it does not erase a structural indentation and can sometimes highlight it.
Age, Hormones, And Weight: Why Hip Dips Change Over Time
The Aging Effect
Hip dips often look more pronounced as the body loses muscle and soft tissue with age. Research suggests adults lose about 3–5% of muscle mass per decade after age 30, with some sources citing up to 8%, which gradually alters lower-body contour and fullness. Paris-based plastic and aesthetic surgeon Dr. Yaël Berdah notes that “older people often have more of this type of hollowness.”
Hormonal Transitions
Falling estrogen during perimenopause and menopause can reduce subcutaneous fat around the hips and thighs and shift fat toward the abdomen. These hormonal changes alter body composition and can make existing hip dips more visible, although the age at which people first notice this shift varies.
Weight Fluctuations
Modest weight gain can sometimes soften hip dips by adding fat around the hips, but it cannot selectively target the indentation and results vary. Most research finds that fat loss is generalized rather than spot-specific, although some newer studies suggest limited spot reduction under specific conditions, such as localized aerobic endurance training of the abdominal region in overweight adult males.
Hip dips remain a lifelong skeletal feature, while age, hormones, and weight shifts mainly change how visible that feature appears.
Evidence-Based Treatment Options For Hip Dips
Non-Surgical Filler Evidence
For people who want to soften the indentation, biostimulatory fillers provide a researched, non-surgical option. Radiesse (calcium hydroxylapatite) and Sculptra (poly-L-lactic acid) have clinical data and reviews supporting their off-label use for hip dip correction, although no filler currently holds FDA approval for this indication. Both products stimulate the body’s collagen production, creating gradual, natural-looking volume in the trochanteric depression over several months, with Sculptra typically building over 2–6 months and Radiesse over 1–3 months, plus an immediate filling effect from Radiesse.
A 2024 case series in Skin Health and Disease reported favorable outcomes and high patient satisfaction for injectable treatment of lateral trochanteric depressions. Sculptra-based hip dip treatments are typically in-office procedures with minimal downtime, and results often last 2–3 years, with maintenance sessions every 1–2 years.1
Why Many Surgeons Prefer Biostimulatory Fillers
Biostimulatory fillers create volume by stimulating collagen rather than simply filling space with gel. Sculptra results usually last 2 to 2.5 years after a full treatment series, with some patients seeing improvement for up to 3 years, and the full effect develops 3 to 6 months after the final session, although manufacturer data emphasize sustained results for up to 2 years.1 This gradual, regenerative effect supports a conservative, safety-focused approach to contouring.
The Surgeon’s Perspective At Mirror Plastic Surgery
At Mirror Plastic Surgery, board-certified plastic surgeon Dr. Akash Chandawarkar personally performs all injectable treatments. His advisory roles with Merz Aesthetics (Radiesse) and Tiger Aesthetics (AlloClae) reflect deep experience with biostimulatory technologies. His guiding philosophy places safety first, function second, and aesthetics third, so every plan balances goals with long-term tissue health.
Mirror Plastic Surgery offers non-surgical biostimulatory filler treatment to soften hip dips, with results tailored to each patient’s anatomy and discussed in detail during consultation.
Frequently Asked Questions
What Is The Main Cause Of Hip Dips?
The primary cause is skeletal anatomy, specifically the gap between the ilium and the greater trochanter. Hip dips are a largely genetically determined anatomical feature present from birth in many individuals, although visibility changes with bone structure, muscle, and fat distribution and can shift with age. Fat and muscle influence how sharply the dip appears, but they do not create the indentation.
Are Hip Dips Natural?
Hip dips are a natural anatomical feature. Cleveland Clinic notes that everyone with typical anatomy has them, although some people see them more clearly than others. Major health organizations, including the World Health Organization and the American College of Sports Medicine, do not classify hip dips as a medical condition and instead describe them as a normal anatomical variation.
Do Hip Dips Get Worse With Age?
Hip dips can look more pronounced with age as soft tissue changes. Age-related muscle loss of roughly 3–8% per decade after age 30, declining estrogen during perimenopause and menopause, and reduced skin elasticity can all exaggerate the appearance of hip dips, although the underlying bone structure stays the same.
Can You Be Lean And Still Have Hip Dips?
Lean individuals often have very visible hip dips because there is less subcutaneous fat to smooth the transition between pelvis and femur. Hip dips appear across all body types and weights, and athletic people with strong glutes and low body fat may show the most defined dips because their bone structure is more apparent.
What Is The Most Effective Non-Surgical Treatment For Hip Dips?
As noted earlier, biostimulatory fillers such as Radiesse and Sculptra are well-documented non-surgical options for softening hip dips, although they are used off-label for this purpose. These products stimulate collagen, building gradual, natural-looking volume in the trochanteric depression over time. Results can last two years or longer with proper maintenance.1 At Mirror Plastic Surgery, injectable treatments are performed by board-certified plastic surgeon Dr. Akash, who evaluates options such as AlloClae adipose filler on a case-by-case basis.
Conclusion: Knowing Your Structure, Choosing Your Path
Current evidence shows that hip dips are a normal, largely genetic anatomical feature created by the relationship between the pelvis and femur. Exercise can influence bone mass more than bone shape, so training and weight changes mainly affect visibility rather than the underlying structure.
Mirror Plastic Surgery offers biostimulatory fillers as a non-surgical way to soften hip dips, with every recommendation grounded in anatomy and realistic expectations. Harvard-educated, Johns Hopkins-trained surgeon Dr. Akash Chandawarkar typically spends up to an hour in consultation to understand your goals and design a plan that fits your unique structure.
Disclaimer: Results may vary from person to person. Editorial content, before and after images, and patient testimonials do not constitute a guarantee of specific results.
1 Results may vary from person to person. Editorial content, before and after images, and patient testimonials do not constitute a guarantee of specific results.
