The movie focuses on Pauline, a teenager struggling to find her place in life, dealing with the hell that is high school, along with her home life where she is under the constant stress of a controlling mother who is desperate for her daughters, both Pauline and her younger sister, Grace (who suffers from Cystic Fibrosis), to be beautiful, proper, popular girls. Pauline is different though, she's an aspiring surgeon with a bit of a dark side. As with most teenagers, her hormones are in full swing, only her dreams are filled not just with sex, but with blood as well. As she explores her own sexuality, her situation at school begins to worsen, as she crosses one of the popular girls, which eventually leads to a physical conflict. Things are going from bad to worse for Pauline, both at school and at home, where her mother is becoming more and more controlling, and her younger sister begins to severely struggle with her Cystic Fibrosis. Seemingly unable to satisfy anyone else, Pauline decides to fix the one thing she feels like she actually is capable of, and Excision closes with a scene that will leave your jaw hanging open.
Well, it may not leave everybody's jaw hanging open, but it did mine. Maybe I was just in the mood for something fucked up, maybe it struck a chord in me that I didn't know was there, I don't know, but Excision really fucked me up. I came away from this one with a feeling similar to the one I got from Martyrs. It didn't go to the extreme that movies like The Bunny Game or A Serbian Film go to, but honestly I almost prefer a movie that is a bit more subtle. It's not a lot of subtlety, mind you, but at least it stops short of baby rape. Again, that could just be me though.
Performance wise, AnnaLynne McCord carries the movie well as Pauline. She's an awkward mess of a girl who really only comes to life when she's giving in to her darker side, and McCord seems to do the same in her performance. Ray Wise, Malcolm McDowell, and John Waters are sadly in limited roles, barely getting any screen time. Roger Bart as Pauline's dad, Bob, ends up being the film's only comedic relief, and there isn't much. You can tell he comes the closest to understanding where Pauline is, and while he doesn't appear to approve of his wife's actions towards her, he isn't willing to confront her either.
Traci Lords goes a long way toward stealing the movie as Pauline's mother, Phyllis. This woman is borderline batshit crazy herself. I'm not talking "Joan Crawford level", but still. At first I almost chalked her actions up to poor writing, as she clearly favors her younger daughter and is basically verbally abusive to Pauline, but the more I thought about the character and her situation, the more I felt sorry for her. She has one daughter whom she feels like she's basically lost at this point, teenagers are difficult enough to live with, but her's is a reclusive with a blood fetish and obvious mental issues, so she's decided to focus on her younger daughter, feeling like Grace is her best chance at having the daughter she's always wanted. The only problem there is, Grace is constantly struggling with her health. I eventually came to realize it wasn't poor writing, it was that Phyllis is just as fucked up as everybody else in Excision.
When the credits finally rolled, this movie did something that very few movies actually do, it left me still thinking about it. That in itself makes Excision a success in my opinion. I would recommend it to just about any horror fan. The film plays primarily to fans of psychological horror, but even gore hounds will find things to like, particularly in Pauline's dream sequences. Excision is smart, disturbing, and extremely well done.