I think Suda 51 is losing it. I'll be honest in saying that while some of the backround enviroments seem interesting, the whole game seemed very generic. Very much unlike his other work which was really trippy.
We've had the entire "hero goes to hell" thing done by a lot of games, "Dantes Inferno" being one of many. The whole darkness and light thing with enviromental effects is also hardly original, with lighting being a major element in games like say "The Darkness" and "Alan Wake".
I'd be more impressed by trying to capture the spirit of a dark musical genere like punk rock in the game's art style, if we hadn't just seem the same thing done with Metal via "Brutal Legend", including all of the skulls and hell-based stuff.
This isn't to say that it's nessicarly bad, just that it seems really generic.
The "Big Boner" actually seems like them trying too hard to come up with something funny and edgy. It came accross as being more dumb than cool due to it's ridiculousness. It's almost like someone looked at say the sexual innuendos involved in the achievements in "Bulletstorm" and how they got a rise out of people, and decided that making a gun called the "big boner" would cater to the same demographic or whatever.
As far as "OMG, how extreme, the guy tattooed an oath to his wife around his neck", again it comes down to trying too hard in an effort to imitate other characters. It seems like an intentional variation on say Dante having a crusader flag stitched onto his bare chest, or Kratos permanantly covering himself with the ashes of his slain family, and other things.
I'd almost suspect Suda 51 was making fun of us, by making a trailer for a game that is so generic that it shows how unoriginal all these other "edgy" games are in imitating each other on all those same concepts... however this seems like a bit too much work for that.