What is the Pencil Test
Place a pencil under the breast (under the fold), also known as the inframammary fold, and if your breasts hold the pencil, then you have sagging. Cosmetic surgeons determine the degree of ptosis (a medical word meaning sagging) according to the position of the nipple relative to that of the crease under your breast or the inframammary fold. The degree of sagging determines the grade of ptosis.
How to perform a Pencil Test
Glandular – Nipples are above the crease under your breast or the “inframammary fold” (nipples above the pencil)
Grade I – Nipples are at the level of the inframammary fold (nipples equal with the pencil)
Grade II – Nipples are below the level of the breast crease, but still higher than the majority of the breast mound (nipples below the pencil, but still more breast below the nipples)
Grade III – Nipples have dropped below the crease and at the level of maximum breast projection (nipples and most breast tissue weighing heavily below the pencil)
Grade IV – Severe sagging, nipples have dropped below the fold, below the mound, and are either pointing toward the floor or even bending back toward the chest wall and non-visible without moving them (at this point, forget the pencil, you need a lift)!