The US release was heavily censored to get an "R" rating rather than an "NC-17". The following scenes were edited:
- The "drill kill" of the girl in the apartment was about 20-30 seconds longer, showing much more blood fly out of the back of her head, and the drill going all the way through her mouth. After the killer retracts the drill, he then begins drilling again into her head. Also, this scene is well-lit as opposed to the darkened version in the "R" rated cut.
- The man getting his head sawed in half; this scene was much longer. More blood and grue flies out as the killer saws, and the aftermath of the top half of the man's head being ripped off was shown, and the camera lingers longer on it when it hits the ground.
- The man being strapped to the table and killed was a bit longer. There were more hits with the hammer, more screams from the man, and a better view of the powder being poured on his head. A more grisly after-view of the man's lye-laden head was present afterward.