What Is Excision About?
The premise of Excision in 286 words, with nothing given away. The full story follows below.
In a modest suburban home where devotion and duty are measured against the ticking clock of a chronic illness, Pauline lives under the watchful eyes of her deeply religious mother, Phyllis, and a weary father, Bob. The family’s routine revolves around caring for Grace, the younger sister whose fragile health casts a persistent shadow over everyday life. Within this tightly knit but strained environment, Pauline clings to an ambitious dream of becoming a surgeon, a path she believes could earn her the approval that seems perpetually out of reach.
Pauline’s world is equally defined by the turbulence of her inner life. She is haunted by vivid, erotic nightmares that intertwine blood and violence, leaving her to wake in a bewildering mix of terror and exhilaration. These unsettling visions fuel a compulsion to explore the boundaries of her own body and desires, prompting her to seek an intimate encounter that mirrors the macabre fascination she cannot shake. As she navigates the awkward terrain of teenage sexuality, the clash between her burgeoning impulses and the strict moral code imposed by Phyllis intensifies, creating a volatile mix of longing and rebellion.
The film unfolds with a tone that balances stark realism and nightmarish surrealism, casting the familiar suburban setting in an almost clinical light. The atmosphere is thick with a sense of suffocating expectation, where the promise of a medical future collides with the raw, unfiltered pulse of adolescent yearning. Amidst the ordinary rhythms of school and family, Pauline’s mind drifts between the ordinary and the grotesque, hinting at a psychological unraveling that blurs the line between her fantasies and the world she inhabits, leaving the audience to wonder how far her quest for mastery—and acceptance—might ultimately take her.
What Happens in Excision?
The complete story of Excision, from the first scene to the last, in 385 words (about 2 minutes). Spoilers throughout. Names in the text link to 6 cast member pages.
Spoilers ahead
Pauline is a disturbed and delusional high school student with a dysfunctional family and aspirations of a career as a surgeon. Her younger sister, Grace, suffers from cystic fibrosis, and the girls’ controlling, strongly Christian mother Phyllis shares a strained marriage with their father, Bob. Pauline often has vivid dreams about herself and others being mutilated with excessive amounts of blood, after which she wakes panting in an orgasmic state.
Pauline decides to lose her virginity to a boy named Adam, and resolves to do so while on her period due to her fascination with blood. She and Adam have sex, and as she has an orgasm, she imagines herself choking Adam and the bed filling with blood. She then asks Adam to perform oral sex on her. Unaware that she is menstruating, he obliges, only to run to the bathroom in disgust when he tastes the blood.
During sex education class, Pauline takes a sample of her blood and puts it under a microscope to check for STDs. She later approaches Adam while he is with his girlfriend Natalie and alludes to their encounter, causing Natalie to break up with him. Natalie and her friend later throw toilet paper and spray paint profanities on Pauline’s house. At school the next day, Pauline assaults both Adam and Natalie, and is consequently expelled.
Pauline overhears her parents discussing Grace’s doctor’s plans to put her on a waiting list to receive a lung transplant. That night, Grace suffers a severe coughing fit. In the morning, Pauline drugs Bob’s tea and ties him up before confronting a neighbor who had rebuffed Pauline’s earlier attempts at friendship. She lures the girl to her backyard and uses chemicals to knock her out, subsequently drugging Grace.
Pauline shaves her own head before transplanting the healthy girl’s lungs into Grace’s body, placing Grace’s diseased lungs on ice, and stitching both girls up. Phyllis arrives home, panics at the sight of Bob bound and gagged, and begins frantically searching the house for her daughters. She finds Pauline in the garage with the bodies. Pauline explains that it is her first surgery and urges Phyllis to take a closer look. Phyllis screams hysterically before embracing her. Pauline at first smiles proudly, but then begins to wail as she seemingly realizes what she has done.
Excision Timeline: Every Key Event in Order
14 key events in the order they happen, from “Pauline's disturbing dreams of violence” to “Ending notes: pride, horror, and realization”. 13 events name a place, across 8 locations.
- 1
Pauline's disturbing dreams of violence
Pauline is a troubled high school student who experiences vivid dreams of mutilation and blood. She often wakes panting and unsettled, hinting at a craving for control through violence. The dreams establish a dark, recurring pattern that foreshadows the events to come.
When:night Where:Pauline's bedroom
- 2
Plans to lose her virginity to Adam on her period
Pauline resolves to lose her virginity to Adam, choosing to do so while she is menstruating because of her fixation with blood. She and Adam have sex, and during her orgasm she imagines choking him as the bed fills with blood. She then asks Adam to perform oral sex on her, intensifying the blood-fantasy.
- 3
Blood check in sex education class
During sex education, Pauline takes a sample of her blood and places it under a microscope to check for STDs. The act underscores her preoccupation with blood and body fluids as a form of power. The moment foreshadows her later, more extreme experiments.
When:During class Where:Sex education class, school
- 4
Pauline hints about the encounter; Natalie breaks up
Pauline approaches Adam while he is with Natalie and alludes to their earlier encounter, provoking tension. The insinuation destabilizes Adam's relationship and angers Natalie, who reacts by ending the relationship. The incident marks a turn toward open retaliation from Pauline.
When:Afternoon Where:School
- 5
Vandalism hurled at Pauline’s house
Natalie and her friend retaliate by throwing toilet paper and spray-painting profanities on Pauline's house. The act demonstrates the volatile social climate around Pauline at school. It heightens Pauline's sense of persecution and isolation.
When:Evening Where:Pauline's house
- 6
Pauline's assault and expulsion
The next day at school, Pauline assaults both Adam and Natalie, shocking students and staff. The violent outburst leads to her expulsion from school. This event marks a clear escalation in Pauline's behavior.
When:Next day Where:School
- 7
Grace’s lung transplant waiting list discussed
Pauline overhears her parents discussing Grace's doctor's plans to place her on a waiting list for a lung transplant. The overheard conversation adds to the family tension and raises the stakes of Grace's condition. The moment plants the seeds for Pauline's drastic actions.
When:Evening Where:Pauline's home
- 8
Grace suffers a severe coughing fit
That night Grace experiences a severe coughing fit, underscoring the seriousness of her cystic fibrosis. The event intensifies the family's urgency and frames Pauline's later actions as a misguided attempt to 'save' her sister. The scene heightens the sense of impending crisis.
When:That night Where:Grace's home
- 9
Pauline drugs Bob and binds him
The morning after, Pauline drugs her father Bob's tea and ties him up, preventing interference as she proceeds with her plan. The act demonstrates how far Pauline is willing to go and how she bypasses family boundaries to pursue her goal. The household descends into a dangerous, controlled chaos.
When:Morning Where:Pauline's home
- 10
Confronting a neighbor and kidnapping a girl
Pauline confronts a neighbor who had rebuffed her, lures the girl to her backyard, and uses chemicals to knock her out. In the same sequence, she drugs Grace, linking the kidnapping with her sister's fragile health. The actions mark a full commitment to her morbid 'surgery' plan.
When:Morning Where:Pauline's home and backyard
Show the other 4 events of Excision Hide the last 4 events
- 11
Shaving her head and beginning the transplant
Pauline shaves her own head and stages the transplant, removing Grace's diseased lungs and attempting to insert the healthy lungs from the abducted girl. She places Grace's lungs on ice as she stitches the patients up. The garage becomes an improvised operating room for a grotesque intervention.
When:Morning Where:Garage
- 12
Phyllis discovers the gruesome scene
Phyllis arrives home to find Pauline in the garage with the two bodies. She screams in horror as she tries to comprehend what has happened. The moment shatters any remaining sense of normalcy for the family.
When:Soon after surgery Where:Garage
- 13
Pauline reveals it's her first surgery
Pauline tells Phyllis that the operation was her first surgery and urges her to take a closer look. Phyllis screams in disbelief, then gradually moves toward a conflicted, frightened acceptance. The exchange destabilizes the mother-daughter dynamic and confirms the gravity of the act.
When:Immediately after discovery Where:Garage
- 14
Ending notes: pride, horror, and realization
Pauline initially smiles at what she imagines as success, but she quickly wails as she grasps the full consequences of her actions. The scene ends with a chilling mix of pride and despair, leaving the future uncertain for Pauline and her family. The film closes on an ambiguous, unsettling note.
When:End Where:Garage
Who Are the Main Characters in Excision?
5 characters, among them Pauline (AnnaLynne McCord), Grace (Ariel Winter) and Phyllis (Traci Lords): who each one is and the part they play in the story. Every profile links to the actor’s page.
- P(
Pauline (AnnaLynne McCord)
Played by AnnaLynne McCord
Pauline is a disturbed, delusional high school student whose fascination with blood and surgery drives her to extreme actions. She orchestrates her own 'first surgery' and uses others as unwilling participants in her disturbing fantasies. Her cold, methodical demeanor masks deep-seated insecurities and a craving for control over life and death.
- 🧠 Delusional
- 🩸 Obsessive
- 👩⚕️ Surgeon-in-training
- 🏠 Family dysfunction
- G(
Grace (Ariel Winter)
Played by Ariel Winter
Grace is Pauline's younger sister who suffers from cystic fibrosis, a fragile figure in need of a transplant. Her illness makes her a target of her sister's perceived 'surgery' and creates the emotional core of the family conflict. Her resilience and vulnerability contrast with Pauline's chilling certainty.
- 👧 Sibling
- 💉 Illness
- 🫁 Transplant recipient
- P(
Phyllis (Traci Lords)
Played by Traci Lords
Phyllis is the controlling, Christian mother whose anxieties about family reputation and Grace's health shape the household. Her protective instincts often feel suffocating, contributing to Pauline's sense of autonomy and rebellion. She embodies the conflict between faith, control, and maternal love.
- 👩👧👦 Overbearing mom
- 🕊️ Religious
- 🧪 Family conflict
- B(
Bob (Roger Bart)
Played by Roger Bart
Bob is the father whose strained marriage and distant presence heighten the family's dysfunction. He becomes a silent witness to the escalating chaos, torn between trying to maintain normalcy and acknowledging the danger in his home. His role underscores the breakdown of parental guidance.
- 👨 Father
- 💬 Marital strain
- 🏚️ Domestic tension
-
Adam (Jeremy Sumpter)
Played by Jeremy Sumpter
Adam is the teenage boy Pauline sex with and whose relationship with her triggers a cascade of social backlash. He becomes entangled in Pauline's dangerous fantasies, experiencing disgust and confusion as the situation spirals. His presence exposes the consequences of Pauline's actions on peer relationships.
- 🧑 Teenage romance
- 🫀 Casual partner
- 🧭 Social consequences
Where and When Is Excision Set?
Excision is set in Suburban family home, Pauline's garage and High school. Here is why the place matters to the story.
Where
Suburban family home, Pauline's garage, High school
The story unfolds mainly in a middle-class suburban home where the family dynamics are in flux. The garage is repurposed as a grim makeshift operating theatre, spotlighting Pauline's disturbing fixation with surgery. School scenes anchor the narrative in teenage life, contrasting the outward normalcy with Pauline's internal chaos.
- 🏠 Suburban
- 👪 Family dynamics
- 🧪 Medical imagery
What Are the Themes of Excision?
3 ideas the story keeps returning to, among them Control, Blood and Family.
-
01
Control
Pauline seeks total control over her world—from her body to the fates of those around her. Her delusions push her to manipulate Grace's life under the guise of care, and she weaponizes knowledge and blood as instruments of power. The family's dysfunction provides fertile ground for her coercive impulses, revealing how control can corrupt intimate relationships.
-
02
Blood
Blood imagery threads through Pauline's fantasies and actions, turning a symbol of life into a sign of danger and eroticized violence. The film juxtaposes menstrual blood with surgical blood, blurring lines between sexuality and harm. The obsession with blood culminates in a macabre 'surgery' that exposes the consequences of unrestrained fantasy.
-
03
Family
The narrative hinges on a fractured family: a controlling mother, a withdrawn father, and a daughter whose mental state distorts family loyalties. The home becomes a battlefield where love coexists with fear, secrecy, and dangerous experiments. The ending suggests that Pauline's actions will forever redefine what 'family' means to Grace and Phyllis.
What Kind of Film Is Excision?
Dark in tone, with steady pacing and a moderate story, going by the plot summary.
- Tone
- Dark
- Pacing
- Steady
- Story
- Moderate
- Intensity
- High
- Ending
- Bleak
A deeply unsettling and intense psychological horror that follows a disturbed teenager's descent into madness, creating a constant sense of dread through graphic fantasies and a grim, oppressive family atmosphere.
- disturbing
- oppressive
- unsettling
- anxious
- gritty
- dysfunctional
- mental illness
- coming of age
- family dysfunction
- chronic illness
Content notes: graphic violence, psychological horror, self-harm (implied shaving), sexual content, gore, bodily mutilation.
Quiz
How well do you remember Excision? Test yourself on the story.
