As someone who found "The Human Centipede II (Full Sequence)" too strident, I can say I found that "American Mary" had a well-needed (and unnerving) realism that adds a kick to the violent scenes, of which there are many. Oh, boy, you have no idea.
Mary Mason (Isabelle) is a seemingly normal, attractive aspiring surgeon who is introduced to the world of Extreme Body Modifications. Want laces sewn through your back? 'Need' horns applied to your head for a more demonic look? Mary is on the job.
But when Mary is attacked at a party, her surgical skills come to good use as she deals with the attacker in the harshest way possible. My first reaction is shock that this 'body modification' thing actually exists. My second reaction is actual pity for Mary's victimizer. No THING, no matter how dastardly, deserves that.
The cinematography in "American Mary" is very prim and professional, and the make-up and gore effects challenge the assumption that 'indie' is synonymous with 'amateur.' I was nearly convinced that the face of the actress who played emotionally damaged plastic surgery freak Ruby Realgirl (Paula Lindberg) was the real deal but I soon discovered that Lindberg was a perfectly lovely blonde.
The mask-like face of modifier Beatriss (Tristan Risk) is equally frightening, though less believably so. The performances were altogether good, and I think Katherine Isabelle has what it takes to become a modern scream queen. Her transformation from everyday college student to morally bankrupt 'underground' surgeon to sadistic, levelheaded, confident killer is compelling and adept.
Directors and sisters Sylvia and Jen Soska (who also appear in the movie as the 'Demon Twins from Berlin' have created a frightening vision of the moral abyss of the surgical world, and the freaks and refuse that exist within it. I couldn't help but feel sorry for the people who would put themselves through surgical Hell in order to deal with deep-seated issues that would be better confronted in the shrink's office.
Ruby Realgirl's bodily obsession was sickening, and you just wanted to tell her to TALK TO SOMEONE- that will help. The movie was really a tragedy in some ways, especially the end. The title "'American' Mary" makes you think after the movie is over about the price of beauty, the price of wealth, and how we define being 'happy' or 'wanted.' It's a bitter pill, but one well worth your time.