I usually dont mind "extreme" pictures...but jeez, this is pretty horrible.

Same here. The content doesn't faze me, but man, what shitty artwork.

Is there supposed to be a vagina in between her balls, or is she giving that dildo a testicle job? And why are those floating hands helping?

Balls in the labia(s). Well, there's something to add to and check off of my list, unless I forgot it... pfft, how can someone forget a concept like the above [pic]?
Also, added "ballcaress".