Can My Wide Hips Be Reduced?

Q: Dr. Eppley, I’m just reaching out to see if there will ever be the possibility of such a surgery being done on a FTM transsexual, since from what I can tell most surgeons would be against it as it’s usually unadvisable to meddle with the hip joint for “cosmetic” purposes. Would it be possible to find someone willing to work with me on surgically reducing the width of the lower part of the hip? What changes to my bone structure would be necessary for this problem to be fixed? My hips are always just a bit too wide at the base and it tends to give me an inherently more feminine shape than if they were more straight. It would be more acceptable if my shoulders were wider, but my shoulders are also quite narrow for a male. I’m already working out and trying to bulk up my upper body, but I can tell that even if I manage to lessen my dysphoria further with CBT and other therapy in general, my hip structure will always be a point of pain for me. I’ve attached the pelvis X-ray for reference if that would help. Is there any chance that needing surgery for this in the future would affect my hip breadth, be it positively or negatively? Thank you for any insight you can offer on this matter. I look forward to your response. 

A:You are referring to reduction of the lateral prominence of the greater trochanter of the femur. This is an area of the femur where a number of musculoligamentous attachments are. Reduction of  this bony prominence requires elevating these attachments which have unknown and potentially adverse short and long-term complications. Most pertinently it may lead to chronic pain and difficulty with walking.  It is also possible that it may lead to long-term osteoarthritis of the femur. As a result it is understandable why surgeons are reluctant for aesthetic purposes to risk this type of complication. It is also possible that such surgery may only create some short-term discomfort and in the long-term be fine. These outcomes and risks are unknown.

That being said I’ve thought about the surgery and patient selection would be of critical importance if it were to ever be done. The patient should be thin where the bony prominence is very palpable and the amount of reduction needed not be excessive. The above unknown risks remain even with good patient selection.

Dr. Barry Eppley

World-Renowned Plastic Surgeon