what combination of anesthesia is the one you apply in the labiaplasty

I use 30% BT cream (Bupivacaine and Tetracaine) about an hour before the case. The patient puts this on their labia at home. Then I use a Plasmaporation to push more cream under the skin through the water channels. Then I use a mix of Bupivacaine+Epi+Bicarbonate and inject under the skin at precise locations using a 30 gauge needle. Works wonders!