There are a few aftermarket wedge professionals that offer customization.  Plus sites like golfwrx.com have specific threads on how to do it yourself.  But officially there are two ways through Titleist:

#1: If you happen to see a Fittingworks Tour Van, those guys will happily custom up a wedge for you.

#2: Take the exclusive opportunity to custom design a TVD wedge with Vokey's Team at Vokey.com.  It takes a little more investment but why not have the best!

RC

what are the chances of seeing a fitting tour van say at a normal golf course. would it be better to go to a titleist demo day and c if it is available

Sitting here with the FittingWorks tour van guys and they said just to qualify Ryan's thoughts - they are happy to help as long as they get all their fitting appointment builds done and have some extra time.  The Tour van schedule is listed under:  http://www.fittingworks.com/FindAFitter.aspx and look under Tour Van.  Right now they are headed to Orlando, FL. for next week and the weekend after and will start back up in February in California and Texas.

If you all ready have custom irons you should know the specs. Any authorized Titlest dealer can order anything you would like. I did this with my 58 - 08 BV wedge. Mine is + 1/2" shaft, 1 degree upright, R200 TT shaft. I got a 52 - 08 BV wedge as a Christmas gift and it is a standard off the rack model. To tell the truth it works just fine as compared to the custom wedge.