A string of sorts is tied tightly around the bottom of the bell and the foreskin, and the foreskin is cut off near the tie. The surgeon trims off extra tissue, and in several days the bell and the remaining dead tissue from the foreskin falls off. In females the circumcision process is less defined. The procedure may remove part or all of the clitoris, labia minora, or external labia. No set procedures are followed since female circumcision, or excision, is practiced much less than male and is often performed in non-medical situations.
Circumcision is most prevalent in Jewish and Muslim traditions.
The United States and Australia are two of only a few countries in which a majority of male babies are circumcised for non-religious reasons. Approximately fifteen percent of the world's male population has been circumcised. Excision is predominantly performed in Africa by a wide variety of tribes and cultures and is performed less frequently in some Middle Eastern regions. In Judaism circumcision is a sign of a covenant with God. In Islam circumcision is highly recommended, but not required, in order to maintain cleanliness.