Anterior vs. Posterior Hip Replacement Scars: What to Expect

Total hip replacement isn’t the marathon it used to be—some patients walk the same day they’re wheeled into surgery. Still, one concern remains universal:

“How will the scar look, and will it behave differently depending on the approach?”

Surgeons now favor two main routes: an anterior incision at the front of the hip and a posterior incision around the buttock. Each leaves its own fingerprint on your skin and heals in a slightly different way. Below is a straightforward, table-free guide to help you visualize what life with either scar is really like.

Getting Your Bearings: Where the Cuts Go

Anterior approach (front)
The surgeon slips between muscles at the front of your thigh and pelvis. Most patients wind up with a vertical line three to four inches long that sits just off the bikini line. Because the incision parallels natural skin-tension lines, it usually lies flat right from the start.

Posterior approach (back)
Here, the incision curves or runs straight down over the top of the buttock—think four to six inches, hidden by underwear. The surgeon must divide gluteal muscle fibers, which can make the scar feel thicker during the first weeks of healing.

Month-by-Month Scar Snapshot

Anterior Scar

• First six weeks: Bright pink, surprisingly flat, and easy to cover with a waistband or swimsuit bottom.
• Month three: Color fades quickly; most scars are pale and supple by now.
• Month six: Often blends into surrounding skin, though the area may feel numb when you kneel or lean forward.

Posterior Scar

• First six weeks: Slightly raised, sometimes “ropey” when you sit because it crosses skin-tension lines. Initial color is the same vivid pink as the anterior scar.
• Month three: Height softens, though fading is slower than with anterior cuts. Expect the area to feel numb or tingly when pressed against a chair back.
• Month six: Thickness almost gone for most patients; color is several shades lighter. Ongoing massage can speed final blending.

Does One Hurt More?

Early discomfort tends to be higher with the posterior incision because gluteal muscles need time to knit back together. Anterior patients often report less pain when standing or climbing stairs, but more pulling when bending forward during the first month. By three months, pain differences even out.

Four-Step Scar-Care Routine

1. Zero to two weeks: keep it simple.
   Pat the incision dry after showering; wear loose clothing. No fancy creams yet.
2. Weeks two to eight: silicone and massage.
   Switch to medical-grade silicone strips or gel for at least half the day. Add five minutes of gentle circular massage morning and night.
3. Months two to six: sunscreen and stretching.
   Fresh scars darken under even weak sunlight, so use an SPF 50 whenever the area could catch rays through clothing. Gentle stretches keep the scar mobile, especially important for posterior patients who sit more.
4. Persistent thickness?
   If the scar remains raised after three months, ask your surgeon about a single fractional-laser session or a tiny steroid injection to calm overactive collagen.

Real-Life Advice from Patients

Jake, 52, anterior hip: “The front scar sits right under my cycling bibs, so I taped it with silicone before every ride. I hardly notice it now.”

María, 64, posterior hip: “It felt like I was sitting on a cord at week six, but soft cushions flattened everything out. By month five I forgot the scar was there.”

Frequently Asked Questions

Will my scar show in a swimsuit?
An anterior scar can peek above a low-rise bikini bottom. A posterior scar hides under most suits but could show in a high-cut style.

Can bio-oil replace silicone?
Oils hydrate but don’t provide the occlusive environment silicone creates. Stick with silicone for eight weeks if you want the flattest result.

Are anterior incisions prone to stretching out?
Only if you jump back into intense hip-flexor workouts too early. Follow physical-therapy advice and you’ll avoid widening the line.

The Takeaway

• Anterior scars are shorter, flatter, and fade faster—but sit where you can see them every day.
• Posterior scars start thicker yet hide behind you and usually soften by month six.
• Consistent care—silicone, massage, sun protection—levels the playing field.

At the end of the day, the true win is a pain-free hip that lets you hike, dance, or chase grandkids. A small, well-managed scar is a fair trade-off for decades of smooth motion.

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