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Jen and Sylvia Soska‘s new film is American Mary.

By the time the Soska twins (Jen and Sylvia) turn up in American Mary – entering a bar that fronts as a high-end cosmetic surgery service that is not for the squeamish – you've been exposed to so much twisted weirdness that you may not notice the leather laces stitched into their backs.

But that's the kind of movie the Vancouver-born writer-director team has – so to speak – stitched together: a journey into delirium-high body-modification fashion fetishism so out there that twin sisters with leather stitching in their backs pass for just another drive-by oddity.

The second feature by this hugely cult-buzzed duo (whose premiere was the daintily titled Dead Hooker in a Trunk), American Mary follows the entrepreneurial innovations of a dropped-out student surgeon (Ginger Snaps' drop-dead dangerous Katharine Isabelle) whose artistry in the customized skin arts flourishes after she exacts an appallingly appropriate revenge on a rapist.

No wonder American Mary has been sparking the fan-based alt-festival underground circuit for the past several months: This is truly a cut above.

American Mary screens on Thursday at 9:30 p.m. as part of Cineplex's Sinister Cinema series at the Yonge and Dundas theatre in Toronto.