Capsular contracture can of breast implants can cause pain
Thank you for your question. Considering your breast implants are over 40 years old and that you have firm painful capsular contractures I strongly suggest that you be examined by a plastic surgeon and have a MRI exam.
For your comfort I would consider removal of the implants and capsule and insertion of new implants if that is your desire. If your MRI shows a rupture the implants should be removed.
I would definitely get a breast MRI and be examined by a plastic surgeon. It is likely that these implants should in fact be removed for health reasons.
Aged implants with contractures and pain
should be removed, especially if gel implants as the gel can get into your tissues. Best to see a local surgeon for further management. And insurance often covers removal.
Grade 4 capsular contraction
Are we talking about gel implants? If so the implants are probably ruptured and the gel(silicone) can migrate into the breast tissue and axillary lymph nodes and cause lumps difficult to tell from breast cancer. Mammograms are difficult to do and more difficult to interpret as these implants are probably subglandular. In my opinion these are health hazards and would strongly consider surgery. I dont think saline implants were available in 1972.
I would suggest seeing a PS and having imaging such as a MRI performed. It is recommeneded that ruptured implants be removed