In this guide14 sections
- Key Points
- Innie vs Outie Vagina: What Is the Difference?
- What Does an Innie Vagina Look Like?
- What Does an Outie Vagina Look Like?
- Is an Outie Vagina Normal? How Common Is It?
- What Causes an Innie or Outie Vulva?
- Innie vs Outie Clitoral Hood: What Is the Difference?
- Why Do So Many Women Worry About Having an Outie?
- Can an Outie Vagina Cause Problems?
- Treatment Options for an Innie or Outie Vagina
- Outie Labia Assessment at Centre for Surgery
- Frequently Asked Questions
- Labiaplasty Consultation in London
- References
Key Points
- What is an innie vs outie vagina? The terms describe the vulva, not the vagina. With an innie, the inner lips (labia minora) sit inside the outer lips (labia majora); with an outie, the inner lips show beyond them.
- What percentage of women have an outie? In a Danish study of 244 women, 56% had visible inner lips, so an outie is at least as common as an innie.
- Is an outie vagina normal? Yes. Measurement studies find a very wide range of labia size, shape and colour, and being an innie or an outie does not affect your health or how the vagina works.
- What causes labia minora to stick out? Mainly the natural shape you develop during puberty. Sex does not make the labia longer, and measurement studies have not found a link with having children.
- Why do so many women worry about having an outie? Seeing images of surgically altered vulvas can shift what women think a normal vulva looks like, which may be why so many healthy women worry.
- Can you change an outie vagina? Only with surgery. Labiaplasty can reduce protruding inner lips for adult women with ongoing discomfort or distress, but it carries real risks and is not appropriate for anyone under 18.
If you have searched for “outie vagina” or “innie vs outie vulva”, you are far from alone. Like the belly button terms they borrow from, “innie” and “outie” describe a visible shape: an innie vagina is one where the inner lips are tucked inside the outer lips, and an outie vagina (sometimes spelt outtie or outy) is one where the inner lips show beyond them. Both are normal, and the outie is at least as common as the innie[1].
Strictly speaking, these words describe the vulva, the external genitals, rather than the vagina, which is the passage inside the body. Most people say “vagina” when they mean the whole area, so this guide uses both words and explains the difference where it matters. For a wider look at how varied the vulva can be, see our guide to the different types of labia shapes. If one side shows more than the other, our article on asymmetrical labia explains why that is common too, and our guide to the “designer vagina” looks at where many of the ideas about how a vulva should look come from.
Innie vs Outie Vagina: What Is the Difference?
The difference between an innie and an outie vagina comes down to how two pairs of skin folds sit in relation to each other:
- Labia majora (outer lips): the fuller outer folds, usually covered with pubic hair after puberty.
- Labia minora (inner lips): the thinner, hairless folds inside them, which surround the openings of the vagina and urethra and run up towards the clitoris.
An innie vulva is one where the labia minora are tucked within the labia majora. An outie vulva is one where the labia minora extend beyond the labia majora, so they can be seen without parting the outer lips. There is no medical dividing line between the two. It is a spectrum, and many women sit somewhere in between or have one inner lip that shows more than the other.
| Innie vulva | Outie vulva | |
|---|---|---|
| Inner lips (labia minora) | Tucked inside the outer lips | Visible beyond the outer lips |
| How common | Common | At least as common (56% in one study)[1] |
| Effect on health | None | None on general health; some women notice rubbing or chafing |
| Needs treatment? | No | No, unless it causes ongoing discomfort or distress |
Innie vs Outie Vulva: Is It the Vagina or the Vulva?
The vagina is the muscular passage that runs from the vaginal opening up to the cervix, so it cannot be an innie or an outie. Its length varies between women, and our guide to a shallow vagina explains what affects vaginal depth. The vulva is everything on the outside: the labia majora, the labia minora, the clitoris and clitoral hood, and the openings of the urethra and vagina. “Innie vs outie vulva” or “innie vs outie labia” is therefore the more accurate phrase, although “innie and outie vagina” is how most people search. In medical terms, they all mean the vulva.
What Does an Innie Vagina Look Like?
With an innie vagina, the outer lips meet or nearly meet in the middle and the inner lips are mostly or completely hidden behind them. From the front you may see little more than a line where the outer lips come together. The inner lips are still there; they simply do not extend as far as the outer lips. An innie does not necessarily mean small inner lips: it can just as well reflect fuller outer lips.
Having an innie vulva is not linked to any health problem. Some women with an innie are more concerned about the outer lips than the inner ones, for example if they look flatter or less full than they would like, which our guide to deflated labia covers in more detail.
What Does an Outie Vagina Look Like?
With an outie vagina, part of the inner lips can be seen between or beyond the outer lips without parting them. How much shows varies a great deal: for some women it is a few millimetres of one edge, for others both inner lips extend well past the outer lips. The visible edge is often a different colour from the surrounding skin, may be wrinkled or smooth, and may be longer on one side. Colour, texture and size all vary widely between healthy women[2].
Very prominent inner lips are sometimes described as labial hypertrophy, but there is no agreed measurement at which normal becomes enlarged. In a Danish study, 1 in 10 women had inner lips at least 26.5 mm wide, and two thirds of the women with the largest labia considered their genitals normal[1].
How Do I Know If I Have an Innie or an Outie?
The simplest way is to look with a hand mirror while standing or squatting, without parting the outer lips. If the outer lips cover the inner lips completely, you have an innie; if any part of the inner lips can be seen, you have an outie. Many women find the answer is “a bit of both”: one side, or just the lower or upper part of an inner lip, may show while the rest is hidden. How things look can also change with position, arousal and the time of the month, so there is no need to check repeatedly. Whatever you see, it is very likely to be within the normal range.
Is an Outie Vagina Normal? How Common Is It?
Yes. An outie vagina is a normal variation, and it is at least as common as an innie. In a 2017 Danish study of 244 women ↗ attending a gynaecology outpatient clinic, 56% had visible labia minora, and the researchers concluded that it is just as common to have visible inner lips as hidden ones[1]. Most of the women in the study, 86.5%, considered their own labia normal. So if you are asking what percentage of women have innies or outies, the best answer from the research is that the two are roughly as common as each other, with outies slightly ahead.
Measurement studies tell the same story. When doctors at a London hospital photographed and measured the genitals of 50 premenopausal women, they found a wide range of values for every measurement, including labia length and width and clitoral size, and the measurements were not linked to age, having children, ethnicity, hormone use or sexual history[2]. One of the largest studies, of 657 white women aged 15 to 84 in Switzerland, set out detailed reference measurements for the vulva and found that the inner lips tended to be shorter in older women, while the outer lips were longer in women with a higher body mass index[3].
What Causes an Innie or Outie Vulva?
Whether you have an innie or an outie, and what causes the labia minora to stick out, is mainly down to the natural shape you develop, in the same way as the shape of your nose or ears. The labia grow and change during puberty, and the final shape is not something you chose or caused. A few points come up often:
- Sex does not make labia longer. In the London measurement study, labia size was not linked to sexual history[2]. Our article on whether sex causes elongated labia looks at this myth in more detail.
- Having children does not reliably change it. Two separate measurement studies found no link between the size of the labia minora and whether a woman had given birth[1][2].
- Age and weight may play a small part. In the Swiss study, the inner lips were on average shorter in older women and the outer lips longer in women with a higher body mass index[3], although the smaller studies found no link with age[1][2].
Can an Innie Become an Outie?
The vulva is not completely fixed for life. It changes through puberty, and how much of the inner lips shows can alter a little with age or changes in weight. Loss of fullness in the outer lips, for example after weight loss or with age, can make inner lips that were once hidden more visible. But no cream, exercise or device has been shown to turn an outie into an innie. The established way to reduce how far the inner lips protrude is surgery, and most women with an outie never need it.
Innie vs Outie Clitoral Hood: What Is the Difference?
When people ask whether the clitoris is an innie or an outie, they usually mean the clitoral hood, the fold of skin that covers the head (glans) of the clitoris. In some women the hood is hidden by the labia; in others it is easy to see. Clitoral size varies widely between women, just as labia size does[2], and a visible clitoral hood is normal. When a prominent hood causes rubbing or discomfort, it can be reduced with clitoral hood reduction, which is often planned alongside labiaplasty.
Why Do So Many Women Worry About Having an Outie?
If outies are so common, why do so many women think theirs is unusual? Part of the answer is that most people rarely see other women’s genitals, and the images they do see, in pornography, advertising or online, may have been selected, edited or surgically altered.
That matters. In a 2014 randomised experiment published in BJOG ↗, 97 women aged 18 to 30 were shown pictures of surgically modified vulvas, pictures of unmodified vulvas, or no pictures, and then asked to rate a new set of images. Women who had first viewed the modified images rated the modified vulvas as more normal than the unmodified ones, and all three groups rated the modified vulvas as closer to society’s ideal[4]. The researchers suggested this may explain why some healthy women seek labiaplasty. In a separate Australian study, women seeking labiaplasty reported more exposure to images of female genitals on the internet and in advertising than women who were not, and had taken those images on board as an ideal to a greater extent[5].
Research on women who ask for surgery points the same way. In a 2011 study at a London teaching hospital ↗, every woman referred by her GP for labial reduction had labia minora within the normal published range, and most of their complaints were about appearance or discomfort[6]. In the Danish study, the women who thought their genitals looked abnormal were more likely to have visible inner lips[1], which is the more common pattern, not an unusual one.
Can an Outie Vagina Cause Problems?
For most women, an outie vagina causes no problems at all. Some women with longer or more prominent inner lips do notice physical symptoms, such as:
- Rubbing or pinching during cycling, running, horse riding or other exercise.
- Irritation and chafing from tight underwear, leggings or swimwear.
- Discomfort during sex, if the inner lips are pulled or tucked in.
- Extra care with hygiene, for example during periods.
Physical discomfort of this kind, along with concerns about appearance, is among the reasons women give when they ask about labiaplasty[5][6]. Simple measures such as looser, breathable underwear, seamless sportswear and a padded or split saddle can reduce friction. If you notice soreness that does not settle, itching, a change in colour or texture, or a new lump, see your GP or a sexual health clinic, as these symptoms can have other causes that need checking.
Treatment Options for an Innie or Outie Vagina
You do not need treatment for an innie or an outie vulva. Treatment is only worth considering if the shape of your labia causes ongoing physical discomfort, or distress that has not eased with reassurance and accurate information. The main options are below.
Labiaplasty for Protruding Inner Lips
Labiaplasty (labia reduction) is surgery to reduce the size of the labia minora so that they protrude less beyond the labia majora. Several techniques are used, such as trimming tissue along the edge of each inner lip or removing a wedge of tissue and joining the remaining edges; our guide to trim vs wedge labiaplasty compares them, and your surgeon will explain which suits your anatomy. A systematic review of 46 studies including 3,804 patients reported high satisfaction rates, but also found that wound breakdown (dehiscence) and concerns about appearance were the most common reasons for revision surgery[7]. Other risks include pain, bleeding, infection, scarring, adhesions, altered sensation, pain during sex and the need for further surgery, and guidance for doctors notes that high-quality evidence on the effectiveness of genital cosmetic surgery is limited[8]. The NHS guide to labiaplasty ↗ sets out what to consider before going ahead.
Labiaplasty before and after photos of Centre for Surgery patients, shared with their consent and blurred because they show intimate anatomy. Tap or click a photo to reveal it, and scroll sideways to see more. Individual results vary. More results are in our labiaplasty before and after gallery.
Labia Puffing for the Outer Lips
Labia puffing works on the outer lips rather than the inner ones. It adds volume to the labia majora using hyaluronic acid filler or a transfer of your own fat, for women whose outer lips look flatter or less full than they would like, which some women notice with age or after weight loss. It does not reduce the inner lips, so it is not a substitute for labiaplasty if protruding labia minora are the concern. Filler is temporary and is gradually broken down by the body, while transferred fat that survives lasts longer, although not all of it survives; our comparison of fat transfer vs filler for labia puffing explains the trade-offs. Possible side effects include swelling, bruising, lumpiness, uneven results and infection.
Is Labiaplasty Right for You?
An outie vulva is normal, so the most useful step for many women is simply knowing that. Guidance for doctors reflects this. The American College of Obstetricians and Gynecologists advises that women considering genital cosmetic surgery should be told about the lack of high-quality evidence, counselled about complications, and assessed for body dysmorphic disorder where indicated, with referral for psychological assessment before surgery if there are concerns[8]. This matters: in a London study of 55 women seeking labiaplasty, 10 met the diagnostic criteria for body dysmorphic disorder, a condition in which worry about a perceived flaw in appearance causes significant distress[9]. The NHS guide to body dysmorphic disorder ↗ explains the signs and where to get help.
Labiaplasty is not appropriate for girls under 18. The genitals are still developing during puberty and these changes can significantly alter the result of surgery, and a review of labiaplasty in minors concluded that education about the wide range of normal genital appearance resolves most concerns, strongly recommending that surgery be postponed until adulthood[10]. UK guidance from the Royal College of Obstetricians and Gynaecologists also advises that genital cosmetic surgery should not normally be carried out on girls under 18. Centre for Surgery does not perform labiaplasty on anyone under 18 or offer them consultations; our article on the minimum age for labiaplasty explains why, and where younger readers can find support.
If you are an adult and decide to go ahead after your consultation, we recommend a two-week cooling-off period before surgery, so that you have time to reflect on the information you have been given. Labiaplasty for appearance alone is rarely funded by the NHS; our guide to labiaplasty on the NHS explains the criteria.
Outie Labia Assessment at Centre for Surgery
Centre for Surgery is a CQC-regulated private hospital at 95–97 Baker Street, London. Cosmetic gynaecology procedures, including labiaplasty, clitoral hood reduction and labia puffing, are carried out by GMC-registered surgeons, under local anaesthetic, local anaesthetic with sedation, or TIVA (total intravenous anaesthesia), depending on the procedure. Our labiaplasty nursing team is all-female, and we treat adults aged 18 and over only.
Your consultation is a chance to ask questions, understand the risks and decide whether treatment is right for you at all. We will examine you only with your consent, and if your labia are within the normal range and not causing you problems, we will tell you so. The surgeon who assesses you is the surgeon who performs your procedure. Our guides to labiaplasty recovery and labiaplasty and sensation cover what to expect afterwards.
Which gynaecology procedure is right for you?
A few short questions about what concerns you. You will get a suggested treatment, realistic recovery times, and a clear answer if you should see your GP first.
Frequently Asked Questions
What is an outie vagina?
An outie vagina is a vulva where the inner lips (labia minora) extend beyond the outer lips (labia majora), so they can be seen without parting the outer lips. It is a normal variation in anatomy, not a medical condition. Strictly, the term describes the vulva rather than the vagina.
What is an innie vagina?
An innie vagina is a vulva where the inner lips are tucked inside the outer lips and are mostly hidden. It is also a normal variation. Neither type is healthier than the other.
What percentage of women have innies vs outies?
In a Danish study of 244 women, 56% had visible inner lips, and the researchers concluded that visible inner lips are just as common as hidden ones. Many women are somewhere between the two, with part of one or both inner lips showing.
How can you tell if you have an innie or an outie?
Look with a hand mirror without parting the outer lips. If the inner lips are completely covered, it is an innie; if any part of them shows, it is an outie. Many women have a mix, with one side or one section showing more than the rest, and all of these are normal.
Is it better to have an innie or an outie?
No. Neither is better, and both are normal. Being an innie or an outie does not affect your general health or how the vagina works, and it is not caused by sex.
Do men prefer innies or outies?
There is no good evidence that partners in general prefer one or the other, and preferences vary from person to person. Research suggests that women’s own ideas of what looks normal are shaped heavily by edited and surgically altered images[4]. A partner’s opinion is never a reason for surgery on its own; how you feel and whether you have symptoms matter far more.
What causes labia minora to stick out?
Mostly the natural shape of your body, which develops during puberty, in the same way as the shape of your nose or ears. Weight change and ageing can make the inner lips more visible if the outer lips lose fullness. Sex, masturbation and tampons do not make the labia minora longer.
Can you change an outie vagina to an innie?
Not without surgery. No cream, exercise or device has been shown to reduce the inner lips. Labiaplasty can reduce protruding labia minora in adults who have ongoing discomfort or distress, but it carries risks and is a decision to take after a full consultation.
Does an outie vagina affect sex?
For most women it does not. A few women with longer inner lips find they are pulled or tucked in during sex, which can be uncomfortable. If that happens regularly, it is worth discussing with your GP or a gynaecologist.
Labiaplasty Consultation in London
If the shape of your labia is causing you discomfort or worry, a private consultation at our Baker Street hospital gives you time to talk it through with a surgeon, without any obligation to go ahead. The consultation fee is £100, redeemable against treatment, and finance is available, subject to status; see our finance options. Learn more about the hospital on our About Us page.
Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation
References
- Lykkebo AW, Drue HC, Lam JUH, Guldberg R. The size of labia minora and perception of genital appearance: a cross-sectional study. Journal of Lower Genital Tract Disease 2017;21(3):198–203. doi:10.1097/LGT.0000000000000308
- Lloyd J, Crouch NS, Minto CL, Liao LM, Creighton SM. Female genital appearance: “normality” unfolds. BJOG: An International Journal of Obstetrics and Gynaecology 2005;112(5):643–646. doi:10.1111/j.1471-0528.2004.00517.x
- Kreklau A, Vâz I, Oehme F, et al. Measurements of a “normal vulva” in women aged 15–84: a cross-sectional prospective single-centre study. BJOG: An International Journal of Obstetrics and Gynaecology 2018;125(13):1656–1661. doi:10.1111/1471-0528.15387
- Moran C, Lee C. What’s normal? Influencing women’s perceptions of normal genitalia: an experiment involving exposure to modified and nonmodified images. BJOG: An International Journal of Obstetrics and Gynaecology 2014;121(6):761–766. doi:10.1111/1471-0528.12578
- Sharp G, Tiggemann M, Mattiske J. Factors that influence the decision to undergo labiaplasty: media, relationships, and psychological well-being. Aesthetic Surgery Journal 2016;36(4):469–478. doi:10.1093/asj/sjv270
- Crouch NS, Deans R, Michala L, Liao LM, Creighton SM. Clinical characteristics of well women seeking labial reduction surgery: a prospective study. BJOG: An International Journal of Obstetrics and Gynaecology 2011;118(12):1507–1510. doi:10.1111/j.1471-0528.2011.03088.x
- Escandón JM, Duarte-Bateman D, Bustos VP, et al. Maximizing safety and optimizing outcomes of labiaplasty: a systematic review and meta-analysis. Plastic and Reconstructive Surgery 2022;150(4):776e–788e. doi:10.1097/PRS.0000000000009552
- American College of Obstetricians and Gynecologists. Elective female genital cosmetic surgery: ACOG Committee Opinion, Number 795. Obstetrics and Gynecology 2020;135(1):e36–e42. doi:10.1097/AOG.0000000000003616
- Veale D, Eshkevari E, Ellison N, et al. Psychological characteristics and motivation of women seeking labiaplasty. Psychological Medicine 2014;44(3):555–566. doi:10.1017/S0033291713001025
- Kalampalikis A, Michala L. Cosmetic labiaplasty on minors: a review of current trends and evidence. International Journal of Impotence Research 2023;35(3):192–195. doi:10.1038/s41443-021-00480-1
