Bethesda complied with the request, but issued a press release declaring their disagreement with the ESRB's rationale. The ESRB reported that Bethesda Softworks, the game's developer, would promptly notify all retailers of the change, issue stickers for retailers and distributors to affix on the product, display the new rating in all following product shipments and marketing, and create a downloadable patch rendering the topless skin inaccessible. In response to the new content, the ESRB conducted a new review of Oblivion, showing to its reviewers the content originally submitted by the game's publisher along with the newly disclosed content.

The sexually explicit content was an art file, made accessible by a third-party modification called the Oblivion Topless Mod, that rendered the game with topless female characters. This included detailed depictions of blood and gore and sexually explicit content. The ESRB cited the presence of content not considered in their original review in the published edition of Oblivion. In May 2006, the North American Entertainment Software Rating Board (ESRB) changed the rating of The Elder Scrolls IV: Oblivion, a video game for PCs, the Xbox 360, and eventually (after the change took place) the PlayStation 3, from 'Teen' (13+) to 'Mature' (17+).

A corpse, identified by Patricia Vance as being 'a very different depiction, far more intense, far more extreme than what had been disclosed to us.'

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