I don't know, you'd be amazed what they can do in photoshop these days. There's a feature in (upcoming CS5? Maybe it was CS4.) with which you select an area, and it Automatically fills in (flawlessly I might add) the area with its surroundings. In one of the feature special look videos they took a road in the desert and completely filled in the road with surrounding desert, with a nice spread of trees, brush, sand, and even zoomed all the way in, you can't tell there was a road there. It's true that most diaper 'shops are obvious, but we could have a professional on our hands.
My opinion however? Staged. Or Europian. Those guys are crazy.