Well , in US and Canada almost nobody has any penile foreskin left (stupidest thing of all stupidest things), so they needed to develop a technique which will result in a decent inner labia, accordingly to that. While this is problem caused because of mutilation of the little innocent babies, it is not the same thing elsewhere. Elsewhere only muslims and jews do this kind of things to their children... If there is enough penile foreskin, it is only smart to use it for inner labia minora. Well, not everybody would agree, obviously... but I do think that Thailand approach like dr. Suporn's makes the most sense where to use it, IF it is available. I'm not shure what they use in case of circumcised foreskin though....