When approaching investors prior to filming, Six did not mention the mouth-to-anus aspect of the plot, fearing it would put off potential backers. The financiers of The Human Centipede did not discover the full nature of the film until it was complete. The film received mixed reviews from mainstream film critics, but it won several accolades at international film festivals. The film was released in the United States on a limited release theatrically on 30 April. A sequel, The Human Centipede 2 (Full Sequence), also written and directed by Six, was released in 2011.
Once the operation is complete Heiter attempts to train his centipede as a pet. During one such session, he watches with great delight as Lindsay is forced to swallow Katsuro's excrement. However, he eventually becomes irritated after being kept awake by the constant screaming of Katsuro (who as the front part of the centipede has his mouth free and is still able to speak) and the realisation that Jenny is dying from blood poisoning. When two detectives, Kranz (Andreas Leupold) and Voller (Peter Blankenstein), visit the house to investigate the disappearance of tourists, Heiter decides to add them to his centipede as replacements for Jenny. Heiter fails in an attempt to drug the detectives, and they leave the house to obtain a search warrant. The victims attempt to escape from the ward, crawling up the stairs, and Katsuro attacks Heiter. Their attempt to escape ultimately fails. Katsuro confesses to the doctor, in Japanese, that he deserves his fate because he had treated his family poorly. Katsuro then commits suicide by slitting his own throat with a piece of glass. The detectives return to the house and conduct separate searches, as Heiter hides near his swimming pool. Kranz finds the makeshift ward and then hears a gunshot. He discovers Heiter's victims before finding Voller dead in the swimming pool. Heiter shoots Kranz in the stomach, and Kranz responds by shooting Heiter in the head. Kranz then falls in the pool, dead. Back in the house, Jenny and Lindsay hold hands as Jenny dies from her infection. Lindsay is left alone in the house, trapped between her deceased fellow captives.
The inspiration for The Human Centipede's plot came from a joke that writer/director Tom Six once made to his friends about punishing a child molester they saw on TV by stitching his mouth to the anus of an overweight truck driver. Six saw this as the concept for a great horror film, and he began to develop the idea. He has said he was heavily influenced as a filmmaker by the early works of David Cronenberg and Japanese horror films. Six has said he prefers horror films that are more realistic over "unbelievable" monster films, and said that he "(gets) a rash from too much political correctness." Major influences for The Human Centipede were Pier Paolo Pasolini's controversial 1975 Italian drama film Salò, or the 120 Days of Sodom, which was notable for its scenes depicting intensely graphic violence, sadism, and sexual depravity, as was the work of Japanese director Takashi Miike. Six has also expressed his love of the works of David Lynch. Further inspiration came from Six's previous work as a director on the Dutch series of Big Brother, where he had been able to observe people who "did crazy things when they were alone and thought they were not (being) watched".
Six has stated that The Human Centipede is, to an extent, a reflection on fascism. Dieter Laser, who played the antagonist Dr. Heiter, said during the promotion of the film that he felt the guilt of Nazi actions during the war had haunted ordinary Germans for generations, and that as a German whose father participated in the war, he often felt "like a child whose father is in jail for murder." The inclusion of a German villain came from this, with Six citing both the German invasion of the Netherlands during World War II and the Nazi medical experiments as inspiration. Laser stated in a interview with Clark Collis for Entertainment Weekly that he considered the film a "grotesque [parody] about the Nazi psyche." Heiter's name was an amalgamation of several Nazi war criminals, his surname (literally meaning "cheerful" in German) a combination of the names of Nazi doctors Fetter and Richter, and his first name coming from Josef Mengele, who carried out experiments on prisoners at Auschwitz concentration camp. World War II also played an influence on the nationality of the other main characters who were American and Japanese. Six includes many horror film clichés in the first act, such as a broken-down car, lack of phone signal and very naïve victims. Six did this in an attempt to lull audiences into thinking they are watching a conventional horror film, therefore making Dr. Heiter's treatment of his victims more shocking. Six placed a Japanese male at the front of the centipede for two reasons: first to create a language barrier between the doctor and the centipede. Throughout the film the characters (with the exception of Heiter who for the most part speaks to the centipede in English) speak in their native languages only (subtitled for the viewer into English where necessary). Katsuro, as the front part of the centipede, can only speak Japanese and therefore cannot speak with either the doctor or Jenny and Lindsay. Secondly, Katsuro's position in the centipede sets up the opportunity for the doctor and the male victim of the centipede to fight toward the climax of the film. Six stated in the director's commentary for The Human Centipede that he has a personal fear of hospitals and doctors, so he stretched out the scene where Heiter explains how he will create the centipede and the subsequent procedure in order to create his "own nightmare".
While seeking funding for the film, Six pitched the idea of a surgeon who sewed people together. He did not initially reveal that the victims would be joined mouth-to-anus, as he believed this idea would stand no chance of receiving investments. His backers felt that the idea of a surgeon sewing people together was original and Six received funding. However, they did not learn the exact details of the film until it had been completed. Six claimed they were very happy with the finished film. Before signing on, the actors were given an outline of the storyboard rather than a complete script. They were also shown sketches of how the centipede would be formed.
Although The Human Centipede is set in Germany, filming took place in the Netherlands due to the countries' similar landscapes. Heiter's home, where most of The Human Centipede takes place, was a villa in the Netherlands found by the production team. The property was in a residential area and not surrounded by woodland as it appears in the film, but by other houses. This meant the filmmakers had some difficulty ensuring the other houses did not appear in shot. Some conversion of the property took place prior to filming, for example, a cinema room was converted to form Heiter's basement operating theatre, with real hospital beds and intravenous drips rented from a local hospital. The paintings of conjoined twins that were displayed throughout the house were painted by Tom Six, which he felt contributed to the atmosphere in the house. The hotel room scene near the beginning of the film was filmed in a hotel suite at a location near Amsterdam. The film was shot almost entirely in sequence, which Yennie stated helped the actors to develop their characters throughout the film. The opening scene, which only featured Laser and de Wit, was shot on the last day of filming.
Laser remained in character as Heiter during the filming process, often shouting at the rest of the cast on set, but wherever possible staying away from the other actors and crew between scenes to preserve a level of separation. He only ate food he had brought onto the set himself, eating mostly fruit. He contributed dialogue for his character and selected many of his character's outfits from his personal wardrobe. Six claims the jacket Heiter wore, which was bought by Laser, was a genuine jacket worn by real Nazi doctors. Laser was also happy for the other actors in The Human Centipede to add their own ideas to the film. For example, when Heiter is explaining his procedure to his victims, Katsuro's dialogue was improvised, which pleased Laser. During filming Laser accidentally kicked Kitamura (Katsuro), leading to a fight on set between the actors. The incident contributed to the tension and anger throughout the scene they were filming, in which Heiter sits at his dining table eating while the centipede eats dog food from the floor alongside him. Laser also hurt Williams during the scene when Heiter roughly grabs and injects Lindsay, which caused a pause in shooting before the filmmakers could continue. The Nazi influence behind Heiter led to the use of classical music when the doctor is "training" his centipede. The music was deliberately played at low quality to simulate the music coming from a loudspeaker, in much the same way as music was sometimes played in Nazi concentration camps. Many of the sound effects in The Human Centipede were created by manipulating meat. For example, the sound of a nose being broken was made by snapping bones within cuts of raw meat. Due to the discomfort of spending long periods on their hands and knees, the actors playing the centipede were given massages at the end of each day of filming. Yennie stated that she and Williams experienced jaw pain from holding a bit in their mouths during filming, but overall she did not feel that the physical side of filming had been excessively difficult. The Human Centipede contains relatively few gory images; little of the surgical procedure is depicted directly, no excrement is shown on screen, and according to Kim Newman in Empire, it is "never quite as outrageous as it threatens to be." Six stated that he wanted the film to be as authentic as possible and claimed to have consulted a Dutch surgeon during the creation and filming process, resulting in the film being "100% medically accurate." Six claims that the surgeon initially wanted nothing to do with his film, as he felt Six was "crazy" and the idea had "nothing to do with medical science." However, the surgeon changed his mind and decided that he in fact liked the idea, and so came up with a method of creating a human centipede. Six has claimed that the central and rear members of the centipede could survive for years by supplementing their diet with an IV drip. The special effects team was led by a father-and-son team, Rob Hillenbrink and son Erik. They designed the final composition of the centipede from sketches provided by the consulting surgeon. The actors that made up the centipede wore hardened underwear, compared by Yennie to shorts, which had a rubber grip for the actors to wear for the actor behind on which to bite, creating the illusion of the mouth-to-anus connection. Six kept how the centipede would be formed a secret until as late as possible, and Yennie claimed even her make-up artist did not know, asking Yennie what kind of "suit" the actors would be wearing.
Once the operation is complete Heiter attempts to train his centipede as a pet. During one such session, he watches with great delight as Lindsay is forced to swallow Katsuro's excrement. However, he eventually becomes irritated after being kept awake by the constant screaming of Katsuro (who as the front part of the centipede has his mouth free and is still able to speak) and the realisation that Jenny is dying from blood poisoning. When two detectives, Kranz (Andreas Leupold) and Voller (Peter Blankenstein), visit the house to investigate the disappearance of tourists, Heiter decides to add them to his centipede as replacements for Jenny. Heiter fails in an attempt to drug the detectives, and they leave the house to obtain a search warrant. The victims attempt to escape from the ward, crawling up the stairs, and Katsuro attacks Heiter. Their attempt to escape ultimately fails. Katsuro confesses to the doctor, in Japanese, that he deserves his fate because he had treated his family poorly. Katsuro then commits suicide by slitting his own throat with a piece of glass. The detectives return to the house and conduct separate searches, as Heiter hides near his swimming pool. Kranz finds the makeshift ward and then hears a gunshot. He discovers Heiter's victims before finding Voller dead in the swimming pool. Heiter shoots Kranz in the stomach, and Kranz responds by shooting Heiter in the head. Kranz then falls in the pool, dead. Back in the house, Jenny and Lindsay hold hands as Jenny dies from her infection. Lindsay is left alone in the house, trapped between her deceased fellow captives.
The inspiration for The Human Centipede's plot came from a joke that writer/director Tom Six once made to his friends about punishing a child molester they saw on TV by stitching his mouth to the anus of an overweight truck driver. Six saw this as the concept for a great horror film, and he began to develop the idea. He has said he was heavily influenced as a filmmaker by the early works of David Cronenberg and Japanese horror films. Six has said he prefers horror films that are more realistic over "unbelievable" monster films, and said that he "(gets) a rash from too much political correctness." Major influences for The Human Centipede were Pier Paolo Pasolini's controversial 1975 Italian drama film Salò, or the 120 Days of Sodom, which was notable for its scenes depicting intensely graphic violence, sadism, and sexual depravity, as was the work of Japanese director Takashi Miike. Six has also expressed his love of the works of David Lynch. Further inspiration came from Six's previous work as a director on the Dutch series of Big Brother, where he had been able to observe people who "did crazy things when they were alone and thought they were not (being) watched".
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Although The Human Centipede is set in Germany, filming took place in the Netherlands due to the countries' similar landscapes. Heiter's home, where most of The Human Centipede takes place, was a villa in the Netherlands found by the production team. The property was in a residential area and not surrounded by woodland as it appears in the film, but by other houses. This meant the filmmakers had some difficulty ensuring the other houses did not appear in shot. Some conversion of the property took place prior to filming, for example, a cinema room was converted to form Heiter's basement operating theatre, with real hospital beds and intravenous drips rented from a local hospital. The paintings of conjoined twins that were displayed throughout the house were painted by Tom Six, which he felt contributed to the atmosphere in the house. The hotel room scene near the beginning of the film was filmed in a hotel suite at a location near Amsterdam. The film was shot almost entirely in sequence, which Yennie stated helped the actors to develop their characters throughout the film. The opening scene, which only featured Laser and de Wit, was shot on the last day of filming.
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