With the new werewolves game pack that's coming to The Sims 4 on June 16th they're adding a Create-a-Sim category for Body Scars. There's been a push for more inclusion in The Sims, and I think to keep that going, adding in top surgery scars into this category would be a huge step forward for trans and gender non-conforming simmers.

While there are custom content options for top surgery scars, it being in the game itself helps bring that inclusion to console players and players that don't use cc.