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Does adding a mod cause any issues with existing saves? Do you have to create a new save to use a mod?

Depends on the mod. Typically, there are no issues, although if you remove a mod after saving, you'll lose items/objects/etc the mod added. And if you saved on an island the mod added, and you remove the mod... that'll corrupt your save.

Cool. Good enough for me. Thanks for the info. I'll continue to enjoy the heck out of this game.