The crocodile enemies in the second level can also bite off arms and every non-robot enemy including the level 2 boss has a vore grapple attack. The death animations include a lot of writhing, spasms and vomiting blood. The ryona here is more violent with no H-content enemy attacks send Nana's body ragdolling through the air and making lovely bone crunching noises on impact. Nana's clothing is damaged by some enemy attacks but she never ends up naked. The new dash move makes the game a tad easy, since you can dash through enemies without taking damage. Most of the enemies and all of the traps are repeats from BlankBlood with updated graphics.
There is a level select option available from the start when selecting new game, but so far there are only two levels a robot factory and a monster infested sewer. The only changes being that now you can double tap left or right to dash and reload using the 'R' key. If you've played BlankBlood then you'll find the controls are almost identical to how Nana was controlled in that game move using WASD and control the gun using the mouse. Like BlankBlood+, where you could only play as Ryoko, here you can only play as Nana.
It's similar to BlankBlood+ and Foxtail with the new multi-part doll graphics. Just found this sequel to BlankBlood and noticed it wasn't mentioned here.