I think some of those most sadistic thing imaginable would stabbing someone under their chin with a shard of glass, using a rusty scalpel to tear someone's lips off while they are still alive (So that when you look at them, they're teeth are visible even though they aren't closing their mouths), put that rusty scalpel in their head and rip it down to the opening between their legs and combine a vacuum cleaner with a razor and shove it up any opening below their legs.
What would you consider sadistic? (For the love of god, no photos. The thought is enough.)