Reporter's Notebook: Pawdicures and Neuticles -- Inside the World of Dog Plastic Surgery

It's usually medical, but sometimes for vanity (the owner's).

March 8, 2012— -- How far do you think a dog owner would go to primp their pooch?

Whatever you're thinking, the answer is: further.

At the Atlanta Dog Spa we met Anais Hayden, a canine creative stylist, who was busy giving a terrier called Frankie Beans a blueberry facial, before giving his friend Boomer Junior a "pawdicure." Yes, a pawdicure.

"Creative styling is where you add a little bit of color," explains Hayden. "Whether that's rhinestones, a little bit of glitter ..."

Watch the full story on "Pet Crazy" Friday at 10 p.m. ET/9 p.m. CT on "20/20"

Her psychedelic creations are astounding. She even paints dogs' nails. And the dog owners -- or "mommies and daddies," as Hayden calls them -- love the results, because their dogs turn heads in the park, and back home they are clean, fragrant and "kissable."

And do the dogs like it? "They love it," replies Hayden, as she brushes Boomer Junior's teeth.

Hayden goes only skin deep. But some dog owners go far deeper in pursuit of canine beauty, tattooing their dogs' flesh (which requires a full anesthetic) and even piercing their ears.

And then there's surgery: plastic surgery. We've heard tell of a Chihuahua in Florida that had liposuction, although only a pound of fat was removed. There's a mutt in South Africa who has been fitted with a titanium nose. An Australian dog called Roland had a brow lift. A Saint Bernard in England had a full face lift. Dogs are injected with Botox, have braces fitted to their teeth, and canine nose jobs are pretty commonplace.

But surely dogs don't care what they look like.

"There's no bikini season for dogs," explains Dr. Marty Becker, a renowned small-animal veterinarian with a clinic in Idaho. "There's no ultra-thin dog models on Animal Planet."

Most Pet Plastic Surgery Medical, but Not Neuticles

No, doggie plastic surgery isn't designed to make vain mutts feel better about themselves. It's almost always for purely medical reasons. A dog that can't breathe might have a nose job; if a dog's teeth don't fit into his mouth, he might get braces; and Botox might stop loose flaps of skin getting into his eyes.

In Yorkshire, England, we met a bloodhound called Junior who's had more work than most. He's had a tummy tuck and a face lift.

"When he leaned forward, basically all of his skin just fell over his face," explained his owner, Denise Smart, on a walk through the woods near the home she shares with Junior, two other bloodhounds, three basset hounds and her equally dog-obsessed husband.

And the tummy tuck? "He wasn't just a bit fat," Smart said. "I mean this was ... It's all been medical; he's had to have it done because of his conditions."

Junior was just born with abnormally loose skin. He would trip over his belly when he ran. Thousands of dollars worth of surgery later, he's far from beautiful, but he's a lot happier. "The main thing," Smart said, "is he can actually see now."

But there is one surgical procedure than cannot be explained as purely medical. "That is the artificial dog testicle," explains Dr. Becker, " or Neuticles.

They range in size from XXS (Chihuahua) to XXL (Great Dane) and sell for as much as $579 a piece. And that's before you factor in surgeon's fees.

"You can have a big-screen TV, or you want to put in a pair of artificial testicles," Becker said. "You make the choice. You want to watch the Super Bowl or March Madness in high def or you want to have Sparky packing a pair?"

And plenty of pet owners are opting for the latter. Nearly a million Neuticles have been implanted in pets around the world. It's a growing business.

One dog who's "packing a pair" is Munson, a 9-year-old English bulldog who lives with his owner, Jim Davenport, in Atlanta.

"They clacked for a little while, but he's fine now," Davenport said.

Munson was a pioneer. One of the early recipients of the synthetic "ball-ternatives." And back in those days, they were made of a more rudimentary material that could be a little noisy.

Like many dog owners, Davenport had little choice but to get his frisky pet neutered. But he harbored some reservations.

"I had another English bulldog that was neutered," he said. "His name was Clinton, and all he did was limp around and mope around after that. He was never the same."

So when a vet friend suggested a pair of Neuticles, Jim laughed and said, "Why not?" The surgery is not complicated. And the dog is on the table getting his real pair taken out anyway. The surgeon just pops the ersatz lug nuts straight in.

And now Davenport is happy because Munson still looks like the real deal, and he seems to have retained his mojo. "He's got good rapport with the female dogs on the street," he said, trying to stifle a smile.

But beyond easing an owner's guilt and empathetic pain, are Neuticles anything more than a cosmetic accessory?

"I try to put myself into the mind of this dog," Dr. Becker said. "Perhaps when they're, you know, lying there on the ground with one leg jauntily up in the air, that it's a more authentic experience that they have something that..." Dr. Becker said, ending the thought amid his own laughter.

But there is a serious side note here. The Neuticles might just make a difference to Munson because they make a difference to his owner. Anything that strengthens the owner-animal bond has got to be a good thing, because a stronger bond means even more love, care and attention for that pet. Plus, dogs know when they're being made a fuss of, and they love the attention.

"And that's what they deserve, "Hayden, the creative canine stylist, told us. "That's what dogs crave. It's attention."

And to maximize that love and attention, it just might take a pawdicure and pristine cuticles, or perhaps a brand new pair of Neuticles.

Watch the full story on "Pet Crazy" Friday at 10 p.m. ET/9 p.m. CT on "20/20"