CAMBRIDGE — Think a nose ring is daring? Forget about it. Think a tongue stud will impress people? Not even close.

If you want to be on the cutting edge of piercing, you’ll have to hang with the big dogs. You’ll have to ride the big wave. You’ll have to take the plunge into the latest youth fashion fad: colostomies.

Teens and 20-somethings from Saugus to Southborough are lining up for the procedure, which re-routes the excretory system into a bag outside the body.

"I’ve never seen anything like it," says Gretchen Reed, manager of the Colostomy Pagoda at the CambridgeSide Galleria. "We used to be lucky to get two walk-in colostomies a month, but now we’re doing two an hour. I don’t have enough surgeons on staff to meet demand."

What’s driving this hole phenomenon? We posed the question to David Foster, one of Boston’s most renowned cosmetic gastroenterologists.

"Young people today want to stand up and be heard," explains Foster, as he lifts his shirt to reveal a blue suede colostomy bag with a rhinestone monogram. "They want to do something shocking, something that lets them express their individuality. That’s why kids think colostomies are so ‘rad’ — there are as many different bags as there are different attitudes."

To see the full array, just visit Maximum Drainage, a new "colostomy gear" boutique in Jamaica Plain. Want to seem casual yet conservative? Try a Levi’s denim bag. Need some skater cred? Get a Dickies canvas bag. If you’ve got more highbrow tastes, Maximum Drainage will let you try on all sorts of designer pouches, from Coach’s hand-finished leather to Prada’s coated nylon.

And if you’re put off by department store prices, you can head up to Freeport’s The Maine Drain, the nation’s first colostomy outlet superstore.

As legend has it, this trend began last year on the beaches of Southern California, where surfers first started showing off their gnarly ‘osto’ bags at drunken beachside luaus. The skateboarding subculture quickly picked up the fad, giving rise to the popular expressions "baggy" (full of shit), "in the bag" (shitty) and "two-bagger" (person with two colostomy bags).

But now colostomies have seeped into the mainstream. The NBA has already sold $1.2 million this year in team-branded colostomy bags, including one that looks and feels like a regulation basketball. And girls as young as 12 are buying "Crapper Keepers," pink plastic colostomy bags featuring defecating ponies and unicorns.

In fact, hip kids are whispering that the colostomy scene is a sellout. They’re moving on to even more extreme forms of piercing.

Like "exo-pancrea-core," where the pancreas is removed and worn decoratively on the forehead. Or "sinal belting," where a decorative woven belt is run in through one nostril, around the entire sinal passage, out the other nostril and tied tightly about the neck. Some poorer neighborhoods are even experimenting with a piercing called "stab in the stomach with a decorative metal rod."

So, as they say, all things must pass. Here’s betting that by 1999, it’s colostomies themselves that’ll be "in the bag."