In October 2011, the BBFC granted the film an 18 certificate after 32 compulsory cuts totalling 2 minutes and 37 seconds were made. The cuts included: Martin masturbating with sandpaper around his penis; graphic sight of a man's teeth being removed with a hammer; graphic sight of lips being stapled to naked buttocks; graphic sight of forced defaecation into and around other victims' mouths; Martin with barbed wire wrapped around his penis violently raping a woman; a newborn baby being killed; and the graphic sight of injury as staples are torn away from individuals' mouths and buttocks