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20 year old saline implants hardened - what could be the cause?

Koremins
I have 20 yr old breast implants. The left has become very hard, and tender (painful at times). A recent ultrasound was normal. Recent mammogram showed no signs of cancer but the report said possible failure of left implant, obstructing views, so mammogram deemed inconclusive. My family doc suggests I see a plastic surgeon. If the implant/s has broken down somehow, will ohip cover removal? How common is this? And what would cause the breast to be very hard on the left side, and the tenderness.

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