Get VA treatment up there every night to plump up the area? If necessary, put 'vagifem' up there this afternoon and another this evening.
Why worry though, who is going to look down there, surgery is drastic and may not improve anything as well as causing more symptoms of VA. Using ovestin on the outer area every night too.
3 a week isn't enough for most, it's a small amount of active ingredient. Every night for ever might be necessary for many.
Trial and Error can be tiring but if you up the dose to nightly, you won't have to think about it.