Will tubular breasts look better with over muscle implants?

Tuberous breast is not, technically speaking, a "yes" or "no" question. There can be different points on the continuum. The typical hallmarks include a high, tight fold with "puffy" or distended areola, minimal breast tissue and potentially herniation of the breast tissue through a tightened ring thus the "tuberous" label. It is a congenital deformity which usually manifests at puberty. To what degree it manifests will vary from one patient to the next.
Treatment of tuberous breasts varies depending on the degree of the breast architectural distortion. Surgical correction typically involves:
-areolar reduction
-submuscular augmentation
-release of constricted breast tissue
All of these techniques work in concert to correct the tuberous deformation of the breast.
With regards to your specific question, some in the past have advocated for subglandular augmentation ("overs") in the setting of a tuberous breast in the hopes of better expanding the lower pole. However, the rise of dual plan augmentation has supplanted this approach. It is the best of both worlds allowing for expansion of the constricted lower pole with none of the drawbacks of an "over" approach.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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Thank you for your question. Generally it is more common to use implants above the muscle for tuberous breasts in order to expand the lower pole easier, however it is not uncommon to place the implant in a dual plan position under the muscle  I recommend a periarelor approach as well  best of luck