I have tuberous breasts. Would you place an implant over or under the muscle? (photos)

Thank you for your question and pictures.
Your picture demonstratesasymmetric breast ptosis along with constriction/tuberous anomaly.
Tuberous breasts  generally have a very narrow base and usually a long skin envelope. In the most severe cases of tuberous breast, a breast lift can be done through an incision around the areola, making the breast into a more rounded shape that the patient will be happy with. In many cases however, a lift is not necessary.
You should be aware that the final result will take months to see and that you will need to be patient.
The incision is usually confined to around the nipple/areola and may require a vertical/horizontal incision (in some cases) as well. The procedure involves making internal incisions to release the tight breast tissues, making a larger space for an implant, rounding out the lower breast crease, and correcting enlarged and protruding areola.  The space between the breasts ( cleavage area)  can be decreased with the use of implants as well.  I usually place the breast implants in the sub muscular (dual plane) position. I also prefer the use of silicone gel breast implants for most patients who present with constricted/tuberous breasts.
Make sure that your surgeon has significant experience with this specific procedure.  I hope this, and the attached link (dedicated to tuberous/constricted breast concerns) helps.

    Either is acceptable, and a good result can be generated with either approach.  I usually place the implants under the muscle.Kenneth Hughes, MDLos Angeles, CA