It means custom sizes in mattresses, which are realitively easy to have made, they just take time and an additional charge.

It also means unique in terms of shape, like round or heart shaped.  These also are available, but usually only in solid foam, wrapped in dacron with quilted pillowing, and they are very, very expensive as a custom item.  But if that's what you have your heart set on, we'll do it.  We might  recommend however that you first check out the European manufacturers/retailers products, because some of these off-standard shapes (round) are a stock item for them. 

(The ?? hotel in Niagara Falls Canada has several suites with heart shaped beads.  You might try giving their management offices a call and asking where they buy them.)

The third category of custom item is the bedframe itself; the head/foot /frame.  We have experience with several different types of custom craftmen in wood, metal, etc., and will be happy to connect you with them, or refer them to you.  We do not as a rule become directly involved in the actual creation and fabrication process.  The extra cost  to cover our participation would make the end price to you unreasonable.