depends on your definition.
what makes HC II so visually gruesome is the fact, that it is so beautifully directed. when you purely go by convincing visuals it is quite hardcore and comparable to serbian movie. cannibal holocaust is to haunting, because of it's "found footage" flair. HC II on occasions is so over the top that it is hard not to laugh out loud. same goes for one particular scene in a serbian film.
when it comes to psyche though, salo is a thousand times harder, due to it's theme of fascism. same goes for men behind the sun and similar films.
as for bmovie trash like august underground and similar (slaughtered vomit dolls ..etc), i find that rather laughable but some people are into this stuff.
personally i find the psychological terror that films like 7th continent, benny's video, 13 beloved, confessions ...etc inflict much harder to swallow.
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