How Can I Give My Pelvis A More Feminine Silhouette?

Q: Dr. Eppley, I’ve been struggling with the shape of my pelvis, and I came across your page regarding iliac crest reduction. I’m currently considering pelvic contouring surgery, and I would like to ask you a few questions. As a woman, I’m concerned that my pelvis appears high and narrow, giving it a more masculine look. Would it be possible to shave or lower the upper part slightly to create a more feminine silhouette?

A: In the high and narrow pelvis you cannot make it wider or have a more feminine silhouette by shaving down the iliac crest. This will simply make it a bit less high but will provide no width to it. The definitive procedure is the application of a titanium iliac crest implant which is designed to do exactly what you want to achieve. This implant sits on the side of the iliac crest and its entire intent is to feminize the pelvis. (see attached diagram) Such implants come in a variety of widths from 15 mms up to 50 mm. The most common widths used is 35 mm but by your own description you may not even need that amount. More accurate sizing depends on knowing your height and weight as well as seeing pictures of the thickness of the soft tissues over your iliac crest. As the widths become greater this can in some patients cause a sub iliac hollow which is which is why in the complete Pelvic Plasy procedure the titanium plate is combined with an attached silicone hip implant. But as long as the width of the implant is not too great and one does not have a pre-existing sub iliac hollow the attached hip implant may not be needed.