The use of local anesthesia for labia puff/fat transfer can depend on the extent of the procedure, as well as the preference of the surgeon and patient. In some cases, local anesthesia may be sufficient to numb the area and make the procedure more comfortable. However, in more extensive procedures or for patients who prefer to be asleep during the procedure, general anesthesia may be recommended. It is important to discuss the use of anesthesia with your surgeon during the consultation process, as well as any potential risks and benefits associated with the procedure. It is also essential to choose a board-certified plastic surgeon with experience in labia puff/fat transfer to ensure the safest and most successful outcome. Best of luck !