High Tension (French: Haute tension, French pronunciation: [ot tɑ̃sjɔ̃]; released in the UK as Switchblade Romance) is a 2003 French horror film that was later released in 2004 in the UK and 2005 in the US and Canada. The film, directed by Alexandre Aja, stars Cécile de France, Maïwenn, and Philippe Nahon. High Tension was picked up by independent distributor Lions Gate Entertainment following a successful screening at the Midnight Madness section of the 2003 Toronto International Film Festival. Originally rated NC-17 in the U.S. for strong graphic violence, a few graphic shots were cut from the final version of the U.S. release to get it down to the R rating (the original NC-17 cut was released in some theaters), and the film was dubbed for commercial appeal. However, the original cut (referred to as an unrated version) is available on Blu-ray and DVD. All of the effects are created by renowned horror make-up artist Giannetto De Rossi, a favorite of late director Lucio Fulci.[3] High Tension has been associated with the New French Extremity movement.