NEW YORK (Wireless Flash) -- Breast implants are one thing, but some folks are so unsatisfied with the size of their nipples that they're having them surgically enhanced.

It sounds like "nip-picking," but according to the American Society for Aesthetic Plastic Surgery, 501 women and 40 men had "breast nipple enlargement" surgery last year.

New York-based plastic surgeon Bruce Nadler performs the procedure on half a dozen people a year and says most do it because they want the "teasing look" of an erect nipple at all times.

Still others -- mostly men -- are nipple fetishists who want their nipples to be the biggest, most desirable nipples possible.

The "super-sizing" is done with injections of collagen or silicone, cartilage taken from the patient's ear or implants.

Dr. Nadler says still more common is nipple reduction surgery, which is done by men who feel their chests look too feminine and women who are self conscious about looking nippy in cold weather.