If horror films are meant to horrify, then “Excision” (2012) doesn’t appear to qualify. But the loose interpretation of the genre isn’t that disconcerting when held to a broader cinematic standard. “Excision” somehow manages to keep us queasy and hungry at the same time.

The film is the feature length writing and directorial debut of Richard Bates Jr. The story follows Pauline (Annalynne McCord), a sickly, quick-witted, socially inept and, most importantly, sociopathic teenager whose obsession with medical procedures and blood permeates all aspects of her life. Her family appears normal enough. They eat together. They live in a nice home in the suburbs. The family matriarch, Phyllis (Traci Lords), is overbearing and just shy of tyrannical. The father, Bob (Roger Bart), is a pushover. Ariel Winter of ABC’s “Modern Family” plays Pauline’s precocious younger sister, Grace, who lives with cystic fibrosis.

“Excision” travels back and forth between the fantasy world of Pauline, rife with sadomasochistic fantasies and art house-ish gore, and the reality of modern American teenage life. It follows the tradition of pinnacle horror films like “Carrie” (1976) in depicting the “social outcast with a dark secret.” But unlike Carrie, Pauline is unconcerned with the politics of high school. Instead, she manipulates her peers to do her bidding, rather than weep at their insults.

Bates Jr. takes plenty of opportunities to tip his hat to other directors. There’s even a small role in the film for famed gore-centric and underground cinematic icon John Waters as a Catholic priest who attempts to counsel Pauline per the request of her parents. The film is riddled with stylistic references to Water’s films – the merging of sex and gore, the “freak” factor, the underplayed and satirized moral soothsayer. Bates’ use of bright colors and high-noon, daylight photography also alludes to films like Mary Harron’s “American Psycho” (2000), which dismantled the long held motif of horror movies as visually dark and perpetually dirty.

Indeed, the clean, methodical and surgical precision of the cinematography adds to the grotesque nature of Pauline’s personality disorder. The film schizophrenically plays with images of cleanliness and filth, premeditation and spontaneity in a way that keeps the audience unsure of the plot’s direction. Hats off to art director Robert Platzer, as well as Anthony Tran for his costume design. Both managed to visually straddle the line between the pristine and deformity.

The acting is as good as the script would allow. The closing scene showcases McCord’s chops better than the build-up hinted at. The rest of the cast smartly and accurately bowed to Pauline’s screen presence in every scene. It’s refreshing to see a disciplined cast unwilling to tip the direction of a film just so they can add something dramatic to their resume.

But after the credits roll, it’s obvious that “Excision” isn’t meant to keep you up at night. The audience is instead left feeling as if they just finished watching an episode of “Unsolved Mysteries,” rather than a slasher flick. It simply doesn’t scare anyone. But that’s not a reason to avoid seeing “Excision” – it’s a reason to reconsider what constitutes a horror film.