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‘The Sims 4’ update adds top surgery, binders, and hearing aids

February 1, 2023
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The Sims 4 has released a free update that adds top surgery scars, binders and shapewear, and medical wearables to the base game. It’s a great step forward for the game’s inclusivity that has disabled and transgender fans rejoicing.

Added in today’s new patch, The Sims 4‘s Create a Sim character creator now offers a Top Surgery Scar, found in the Body category’s new Body Scars subcategory. Players can add the Top Surgery Scar to any male Sims aged Teen or older, regardless of if their base body model is masculine or feminine. Top surgery scars indicate the person has undergone surgery to remove their breasts.

SEE ALSO:

‘The Sims 4’ is now free to play, so say goodbye to your social life

Gender-affirming clothing items have also been added to The Sims 4 for the first time. The game’s new Binder can be found in Create a Sims’ Tops category, sub categorised under Tanks, while Shapewear is categorised as Underwear in the Bottoms section. These clothing options are often used by transgender and non-binary people to help them alleviate gender dysphoria.

These are significant additions to The Sims 4. The game’s character creation has allowed players to mix and match masculine and feminine traits regardless of gender since 2016, and updates last year enabled them to choose Sims’ sexual orientations and pronouns. However, today’s update is the first time Create a Sim has included such overt and unequivocal physical indicators of trans identities on characters’ bodies. 

The Sims 4 fans immediately began rejoicing at the news.


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These weren’t the only inclusive upgrades in The Sims 4‘s Jan. 31 update(Opens in a new window). The game also added medical wearables, specifically hearing aids and glucose monitors.

Found under the new Medical Wearables subcategory in Create a Sim’s Face customisation menu, The Sims 4‘s hearing aids can be given to all Sims that are Toddler-aged or older. They come in 15 different colours, so particularly stylish Sims can match their hearing aid to their outfit, and can be placed in Sims’ right ears, left ears, or both.

Glucose monitors can be found under the new Medical Wearables subcategory under the Body category, and are available to Child-aged Sims and above. Like The Sims 4‘s hearing aids, these medical devices offer some customisation by allowing players to put them on a Sims’ right or left arm, or the right or left of their lower abdomen.


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All of The Sims 4‘s new assets are merely aesthetic additions, so your Sims won’t have any difficulty hearing if you remove their hearing aids. Similarly, the game’s binders don’t actually flatten Sims’ chests(Opens in a new window), and their categorisation as Tops means Sims can’t wear shirts over them like binder wearers would in real life.

This doesn’t make the additions any less meaningful though, allowing players to see themselves at least slightly more accurately portrayed in the popular life simulator.

The new items’ lack of functionality also means Sims can wear binders 24/7 without any adverse consequences to their health(Opens in a new window), so it could be considered an improvement over reality in at least some areas.


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The Sims 4‘s update further added some improvements to console players’ experience, such as allowing them to make their cursor larger and keeping the Build Mode’s Catalog open while players grab and move items. Though most attention is understandably squarely on the game’s new inclusive content, these are a few great quality-of-life additions for anyone playing on Xbox or PlayStation.

If you want to check out the update yourself, The Sims 4 has been free to play since late last year. Just maybe set a timer so you don’t get sucked into playing for the entire day.

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