The band initially included Manson on vocals with Bates and Paul Wiley on electric guitars, Twiggy on bass and Sharone on drums. during which they debuted several new songs. During this leg of the tour, the group narrowly avoided injury in
Moscow when their tour bus was involved in a collision with a
semi-trailer truck, The North American leg began on September 27, and was scheduled to incorporate performances at several
music festivals, including the
Aftershock Festival on October 22, at which
Nine Inch Nails was also scheduled to appear. Manson indicated a possibility of joining that band on stage during the festival, after he and
Trent Reznor mended a longstanding feud. However, Manson was injured on several occasions during the tour. He sprained his left ankle after jumping off the stage at Pittsburgh's Stage AE on September 29. The following night, at the Hammerstein Ballroom in New York, he was crushed by a large
stage prop, and lay unconscious on the stage for up to 15 minutes before being carried out of the venue on a
stretcher to a nearby hospital. Manson had broken his
fibula in two places, requiring a plate and ten screws to be inserted into his bone. including their appearance at Aftershock, with all dates – excluding festival appearances – rescheduled to take place at the start of 2018. On October 25, Manson announced he had "decided to part ways" with Twiggy after the bassist was accused of sexual assault by former girlfriend
Jessicka Addams, who was the vocalist for alternative rock band
Jack Off Jill. Addams said the incident occurred while she and Twiggy were a couple in the mid-90s. He was replaced on subsequent tour dates by former
Racer X and the Mars Volta bassist
Juan Alderete. Alderete's first show with the band, at the
2017 Ozzfest Meets Knotfest festival in
San Bernardino on November 5, found Manson performing in a wheelchair as a result of injuries he sustained earlier in the tour. Manson attracted criticism from some publications after he used a replica
assault rifle as a microphone during the concert, with some commentators arguing it was insensitive considering the city had previously been the subject of a
terrorism-related attack, and that the concert took place hours after the
Sutherland Springs church shooting in Texas. ; he sustained injuries during this show that resulted in the rescheduling of an entire leg of the "
Heaven Upside Down Tour".|alt=Image of the band's vocalist using stilts and wearing a long robe made of black feathers. In his hands are two elongated stilts, which he is holding aloft. The background of the stage is illuminated with orange stage lighting, and in the foreground numerous fans can be seen giving the 'devil-horns' signal. The day of the 2016 US presidential election, a short teaser clip for "
Say10" was released. Created by director
Tyler Shields, it featured images of Manson holding a bloodstained knife while standing above a decapitated corpse lying in a pool of blood. Numerous publications noted the corpse was dressed in similar clothing to the kind regularly worn by Donald Trump—a suit and red tie. Manson would later say the decapitated figure in the video "wasn't anyone except if you wanted it to be them." "We Know Where You Fucking Live" was issued as the album's
lead single on September 11, after premiering on
Zane Lowe's
Beats 1 show. and was directed by Bill Yukich and
Perou. "Kill4Me" was issued as the album's primary airplay single in the United States, where it went on to become their highest peaking single ever on the
Billboard Mainstream Rock Chart. A series of advertisements created by Canadian
pop artist
Alex Kazemi to promote the album on Instagram were leaked online in late September, but were deemed too graphic to be used on the image hosting service. Music videos were subsequently released for "Say10" and "Kill4Me", both directed by Yukich and featured actor
Johnny Depp. A cover of "
God's Gonna Cut You Down" – recorded during the
Heaven Upside Down sessions "
Tattooed in Reverse" was serviced to
active rock radio formats in the United States as a promotional single on March 6, 2018, and peaked at number 35 on
Billboards Mainstream Rock Chart. This made
Heaven Upside Down the band's first studio album since 1998's
Mechanical Animals to contain more than one charting song on Mainstream Rock. and featured singers
Courtney Love and
Lisa Marie Presley. Yukich also directed the music video for the band's cover version of
Gerard McMahon's "
Cry Little Sister", released in June and recorded for the soundtrack of
The New Mutants. The band embarked on a second co-headlining tour with
Rob Zombie on July 11, 2018, titled "
Twins of Evil: The Second Coming Tour", following the "
Twins of Evil Tour" in 2012. On the day the tour began, Zombie and Manson released their cover of the Beatles track "
Helter Skelter", which featured former Manson band members
John 5 and
Ginger Fish.
Heaven Upside Down was the last album to feature Sharone, who departed the band in March 2019. He was replaced on the subsequent "
Twins of Evil: Hell Never Dies Tour" by former
Black Flag and
Ho99o9 drummer Brandon Pertzborn. Shortly after the tour completed, Alderete was involved in a bicycle accident which left him with a
diffuse axonal injury, a type of
traumatic brain injury. A
GoFundMe page was created to help cover the cost of his medical expenses. Despite this, Alderete is a credited performer on the band's next studio album, 2020's
We Are Chaos. ==Critical reception==