Do I Need A Breast Lift? The Pencil Test vs. The Pinch Test

Posted November 14, 2015 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Tubular Breasts

One of the most frequent questions I get during a Breast Augmentation consultation is, “Do I need a breast lift?” The decision is based on anatomy and how we define the ideal breast. The answer is the ternary: yes, no and maybe, and can often be determined by the Pinch Test.

The Pencil Test

Every woman seems to know about the Pencil Test, but the Pinch Test is better for determining if a Breast Lift is needed.

Every woman seems to know about the Pencil Test, but the Pinch Test is better for determining if a Breast Lift is needed.

It seems every woman is familiar with the Pencil Test. A pencil is placed along the fold under the breast (the inframammary fold or IMF). The breast is released, and then the pencil is released. If the pencil falls, you pass the pencil test, and there is no breast sagging. If the pencil is held in place, then you fail, and there is sagging. But does this really mean you need a Breast Lift?

Passing the Pencil Test

The woman above passes the pencil test. She has no sagging, so Breast Augmentation with Breast Implants is all that is needed to enlarge her breasts.

The woman above passes the Pencil Test. She has no sagging, so Breast Augmentation with Breast Implants is all that is needed to enlarge her breasts.

The Pencil Test is a simple test, but it is too simple to determine whether a Breast Lift is necessary. If you pass the Pencil Test, it is unlikely that you need a breast lift. Like every good rule, there are exceptions. For situations like Tubular Breasts, the Pencil Test is passed; however, the nipple is puffy and too low, so a lift is used to reshape the areolae and reposition the nipple higher on the breast into a more aesthetic position.

Failing the Pencil Test

The woman above fails the Pencil Test. Since her nipples are lower then the fold under her breasts, she also fails the Pinch Test (as described below) and needs a Breast Lift to provide the best aesthetic result.

The woman above fails the Pencil Test. Since her nipples are lower then the fold under her breasts, she also fails the Pinch Test (as described below) and needs a Breast Lift to provide the best aesthetic result.

On the other hand, failing the pencil test does not necessarily mean you need a breast lift. It does place you into the group more likely to need a lift, but the position of the nipple on the breast is equally important in this situation. When the nipple is low, a breast lift is needed. If the nipple is high, Breast Augmentation alone may be corrective. This brings us to the Pinch Test.

The Pinch Test

If you fail the Pencil Test, the Pinch Test helps to sort out if you would benefit from a Breast Lift or not. It is a simple test that determines the height of the nipple with respect to the level of the inframammary fold (IMF). When the nipple is below the IMF, a breast lift is usually recommended. When the nipple is above the IMF, a breast lift is usually not necessary. If the nipple is at the level of the IMF, then you are on the border line, and more discussion with your chosen Board Certified Plastic Surgeon is needed.

How to Perform the Pinch Test

When testing your breasts, it is easiest to used you opposite hand. If you are checking your left breast, place the tips of your right middle and ring fingers in the center of the fold under the breast, in line with your nipple. You should slide your finger tips up to the junction between the bottom of the breast and the abdominal skin without pushing the breast up. Your thumb should remain in front of the breast. Keeping your thumb over the front of the breast, bring the thumb tip toward the tips of the middle finger and lightly pinch the breast.

Passing the Pinch Test

The woman above fails the Pencil Test, but passes the Pinch Test.  Breast Implants alone can correct this type of "Fake" sagging or pseudoptosis.

The woman above fails the Pencil Test, but passes the Pinch Test. Breast Implants alone can correct this type of “Fake” sagging or pseudoptosis.

If your thumb tip pinches the breast below the nipple, a Breast Lift is usually not needed. A Breast Implant will provide fullness and support the nipple. So Breast Augmentation alone with take care of this type of sagging, as the Breast Augmentation Before and After Pictures above illustrate.. The Plastic Surgery term for sagging is ptosis. This type of sagging, which does not require a Breast Lift, is called pseudoptosis, or fake-sagging.

Failing the Pinch Test

The woman above fails both the Pencil Test and the Pinch Test, but a good result is still achieved with a combination of Breast Augmentation and Breast Lift. The Breast Augmentation increases volume, while the breast lift corrects the shape.

The woman above fails both the Pencil Test and the Pinch Test, but a good result is still achieved with a combination of Breast Augmentation and Breast Lift. The Breast Augmentation increases volume, while the breast lift corrects the shape.

If your thumb tip touches the breast above the nipple, a breast lift is usually needed. The ideal nipple position is located at the front of the breast. The problem with the nipple located below the IMF is that the Breast Implant will push the nipple further down on the breast. This is not ideal, and the Breast Lift is the remedy.

On The Fence With The Pinch Test

If your thumb tip touches at the level the nipple, you are on the fence. If you are comfortable with the nipple being lower on the breast, a lift may not be for you. If you feel your nipple has always been low, and you’d like it higher, then a Breast Lift is the solution. For borderline cases, a smaller lift, like a Peri-Areolar Breast Lift, is usually sufficient. Only an in-person consultation can tell for sure.

Breast Augmentation Lift Consultations

If you are considering Breast Augmentation, and are wondering if you need a lift, the Pinch Test can help, but only an in-person consultation can provide you the full picture. The best plan for you will be determined, only by a focused medical history and exam, and a discussion of what you expect the procedure to do. If you would like to learn more, call (925) 943-6353 to schedule a private breast augmentation / lift consultation appointment today.