Is it true that they remove tissue and fat during a breast lift?

Yes, during a breast lift, a certain amount of skin and breast tissue is removed. It is best to discuss with your plastic surgeon your postoperative expectations. Discussing this with your surgeon would give you an idea of how much smaller you could expect to be. If you do not wish to be smaller post op, you could discuss breast implant options to restore upper pole fullness.

A small reduction can be done at the same time as the lift, or a lift only with just skin removal can be done if the breast amount is not excessive. A breast reduction does include a lift unless it is done with liposuction,

I have had this question asked many times in my office in preparation for a breast lift (aka Mastopexy) and the answer is the following: "you have to nip/ tuck something to go from one position to another." It is however rare to be removing anything that is critical to breast function and that would be able to be saved if you want a different shape of your breasts. Best Wishes!!