A senior character artist on The Sims, Jess Hyland, has praised rival life-simulation game Paralives for allowing characters to wear mismatched shoes and earrings, saying she wishes The Sims could do the same. Speaking at the Develop conference following a talk on how The Sims 4's character creator has evolved since 2014, Hyland noted that Paralives' underlying system also allows for features such as a single prosthetic leg without needing to replace both feet, something currently impossible in The Sims due to how its symmetrical character models are built.

Hyland explained that Sims characters are symmetrical by default, with asymmetry only introduced through non-mirrored items such as clothing, hairstyles or tattoos, meaning a prosthetic leg would require creating an entirely separate, non-interchangeable asset. She said such a change would be desirable but require significant work, and pointed to a precedent: in 2015, EA overhauled The Sims 4 to decouple gender presentation from clothing options, a difficult task involving two different base character meshes that was ultimately solved using an invisible "cummerbund" mesh to unify differing waistlines. Paralives entered Steam Early Access at the end of May.