Q: Is it possible to enlarge vaginal size? A: Yes, it is possible, but the cause of the narrow vaginal caliber must be established before conservative or surgical treatment can be offered. I do not intend to market my practice by sharing my experience and factual knowledge with you and other women who have the same medical dilemma, but it is designed to help women and doctors. 1. A target vaginal examination is necessary to determine the cause of the feeling sensation of the narrow vagina to rule in or out the following conditions: a) dry vagina, b) compromised stretching ability, c) shorter vagina, d) contracted or underdeveloped vaginal outlet that recently I discovered anatomy of it and documented the presence of different layers of the hymeneal outlet– the hymeneal membrane, hymeneal ring, and hymeneal plate (pending publication). Additionally, my study determined that the vaginal outlet gross, topographic anatomy and histology differ from the vaginal wall, e) the hymeneal ring and hymeneal plate contraction can cause a sensation of the narrow vagina, f) developmental abnormalities such as atresia [urogenital plate not fully developed] or agenesis (the upper part of the vagina is not properly developed - Müllerian Agenesis. 2. The pineal size is too large to admit into the vaginal canal. The treatment options: 1. Conservative therapy uses plastic or vaginal metal dilators. I use the vaginal dilator made by me from a bee wax comb and changing the dilator’s size incrementally as needed. Also, my dilator prevents the creation of sores that metal or plastic dilators can cause when used for a long time, 2. Surgical therapy:a) vaginal outlectomy (only the tiny fragment of the hymeneal ring and hymeneal plate are excised). It is a very similar procedure as a new episiotomy (Ostrzenski’s vaginal outlectomy) technique without incising the posterior perineum (pending publication), b) appropriate surgery for Müllerian agenesis or vaginal atresia should be implemented. Summary It is essential to select a doctor who can establish a definitive diagnosis of your condition and then select a doctor experienced in conservative treatment of narrow vaginas. Additionally, a surgeon must be chosen carefully. With regards,Prof. Dr. Adam OstrzenskiUS Gynecologic Cosmetic-Reconstructive Surgeon