How do tube manufacturers like VAC get 55 watts per KT88 where others get only 30-35?

Just wondering how some push pull tube manufacturers like VAC and others get 55 watts per KT88 tube while others are more in the range of 35? Does driving a tube hard like this have any ramifications as to distortion, sound, headroom and tube life? I know VAC amps are highly musical so design, power supply and output transformers obviously contribute much to overall sonics. A company like Zesto gets about 25 watts per KT88 but uses a class A push pull circuit rather than class AB.  This seems like an attractive design.
I guess, as always, it's all in the implementation. Thank you for helping me to better understand.