Notice of Data Incident
August 1, 2023

Dear Patients:
We post this Notice pursuant to the United States Health Insurance Portability and Accountability Act (“HIPAA”) to inform you about a data incident involving an unauthorized release of patient Protected Health Information (“PHI”), as that is defined by HIPAA, at Gary Motykie, M.D., a Medical Corporation and Gary Motykie, M.D. (“Practice”), a covered entity under HIPAA.

PHI, as defined by HIPAA, is information that is “created, received, maintained, or transmitted by or on behalf of the health care component of the Covered Entity.” § 164.105 (a)(2)(i)(D). Information that is created or received by a Covered Entity and that relates to the past, present, or future physical or mental health or condition of an individual; or the past, present, or future payment for the provision of healthcare to an individual is considered PHI. PHI is required to be protected when transmitted or maintained in any form by a Covered Entity. Individual identifiers (including but not limited to name, address, telephone number, fax, email address, social security number, medical record number, etc.) maintained in a designated record set along with health information (including but not limited to x-rays, images, scans, physician notes, diagnoses, treatment, eligibility approvals, claims, remittances, etc.) are collectively considered PHI.

Event Description:
On or about June 6, 2023, an initial technical analysis of the Practice’s information technology network determined an unauthorized release of PHI occurred to an unknown third party. The initial analysis determined that the unknown third party accessed the Practice’s network. It was further determined that the unknown third party acquired some of the Practice’s patient’s unencrypted PHI and that party was not authorized to do so and did so in an unlawful manner.

The information that may have been accessed or acquired during this unauthorized access included:

  • First and last name 
  • Social Security Number (if provided)
  • Address
  • Driver’s license or identification card number
  • Financial account or payment card number, in combination with any required CVV code
  • Intake forms, which may include medical information and history
  • Images taken in connection with the services rendered at our office
  • Health insurance information (if provided)
Steps Taken to Address:
Upon discovery, the Practice took the following immediate steps to address the situation:
  • Computers and servers replaced
  • Network passwords changed
  • Endpoint detection, virus, and malware detection tools and software installed on workstations and server
  • Limitations concerning Internet access
  • Access controls put in place for users based on role and responsibility
  • Server policies in place
  • Device locking mechanisms
  • Multi factor authentication enabled
  • Network segregation efforts
  • Encryption of devices
  • Additional workforce training
Risk Assessment:

The Practice conducted a risk assessment to evaluate the potential harm to potentially impacted individuals. Based on that assessment, it is determined that there is a high risk of harm. It is essential for potentially impacted individuals to remain vigilant in monitoring their personal accounts and data and promptly report any suspicious activity to law enforcement or their financial institutions.

Assistance and Resources:
Starting on or about June 22, 2023, letters were mailed to patients providing the following resources to assist the potentially impacted individuals, offering at no cost:
  • two (2) years of no cost Triple Bureau Credit Monitoring/Triple Bureau Credit Report/Triple Bureau Credit Score/Cyber Monitoring services.
  • the services also include reviewing whether Information appears on the dark web and alert the individual if such Information is found online.
  • proactive fraud assistance to help with any questions in event a potentially impacted persons becomes a victim of fraud.

Steps to Prevent Future Incidents: We deeply regret any inconvenience or concern this Incident may cause. The Practice is taking numerous steps to help prevent similar Incidents in the future. We will continue to review and enhance our security measures, policies, and employee training.

If you failed to receive your letter in the mail, and/or if there is a concern your mailing address has changed since you were a patient at the Practice, please contact 1-800-405-6108 or call our office immediately at 310-246-2355 from 9:00 am to 5:00 pm Pacific time, Monday through Friday.

Skin Reduction & Body Contouring

What is body contouring after major weight loss?

Skin Reduction & Body ContouringBody contouring after major weight loss improves the shape and tone of your underlying tissue that supports fat and skin and removes excess sagging fat and skin.

Enhancing your appearance with body contouring surgery

Following weight reduction surgery, or any substantial amount of weight loss, the skin and tissues often lack elasticity and cannot conform to the reduced body size. As a result, skin that has been severely stretched now is unsupported:

  • Upper arms may sag and appear loose and full
  • Breasts may flatten and hang with nipples pointed downward
  • Abdominal area may extend around the sides and into the lower back area, resulting in an apron-like overhang
  • Buttocks, groin and thighs can sag and cause hanging pockets of skin

Surgical body contouring following major weight loss improves the shape and tone of your underlying tissue that supports fat and skin, and removes excess sagging fat and skin.

The result is a more normal appearance to the body, with smoother contours. This is, in essence, the final phase of your total weight loss experience.

Gallery It's Your Right to Feel Beautiful

Is it right for me?

Before you decide to undergo body contouring following major weight loss, your weight loss must be stabilized.

  • If you continue to lose weight, sagging pockets will redevelop.
  • If you rapidly regain the weight, you will traumatically stress your already weakened and thinned skin, causing further stress to the skin, visible stretch marks and wide scars.

If you had weight reduction surgery, your plastic surgeon will work closely with your physician to determine when it is appropriate for you to begin body contouring.

Good candidates for body contouring are:

  • Adults of any age whose weight loss has stabilized
  • Healthy individuals who do not have medical conditions that can impair healing or increase risk of surgery
  • Non-smokers
  • Individuals with a positive outlook and realistic goals for what body contouring can accomplish
  • Individuals committed to leading a healthy lifestyle including proper nutrition and fitness
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What to expect during your consultation

The success and safety of your body contouring procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

  • Why you want the surgery, your expectations and desired outcome
  • The options available in body contouring surgery
  • Medical conditions, drug allergies and medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Previous surgeries

Your surgeon may also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Examine and measure your body, including detailed measurements
  • Take photographs for your medical record
  • Discuss your options and recommend a course of treatment
  • Discuss likely outcomes of your surgery and any risks or potential complications

Preparing for surgery

Prior to surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

  • What to do on the day of surgery
  • The use of anesthesia during your body contouring surgery
  • Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Body contouring surgery may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

You’ll need help

If a component of your body contouring surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Procedural Steps

What happens during body contouring surgery?

The procedures necessary to achieve your goals will be defined along with a plan for the timing of these procedures. Plastic surgery procedures that may be recommended by your physician include:

  • Lower body lift: to correct sagging of the abdomen, buttocks, groin and outer thighs
  • Breast lift: to correct sagging, flattened breasts
  • Arm lift: to correct sagging of the upper arms
  • Thigh lift: to correct sagging of the inner, outer and mid thigh

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

All body contouring procedures require incisions to remove excess skin. In many cases, these incisions may be extensive.

Incision length and pattern depend on the amount and location of excess skin to be removed, as well as personal preference and your doctor’s surgical judgment.

Advanced techniques usually allow incisions to be placed in strategic locations where they can be hidden by most types of clothing, but this is not always the case.

Body contouring is often performed in stages. Your particular condition and goals, as well as your plastic surgeon’s best judgment, will all influence how your doctor defines a surgical plan. While it may have taken you two years or more to lose all the excess weight, it may take equally as long for the results of your body contouring to be complete.

Body Lift

A complete lower body lift treats sagging buttocks, abdomen, waist, hips and outer thighs in one procedure or in staged procedures. Incision patterns vary, and may include a circumferential incision around the body to remove the “belt” of excess skin and fat.

Breast Lift

The incision patterns for lifting a woman’s sagging breasts will be determined based on the amount of excess skin to be removed.

These may include one or a combination of incisions in a circular pattern around the areola, in a line extending from the areola to the breast crease, and horizontally along the breast crease.

A breast implant also may be recommended to enhance breast shape and size.

Arm Lift

Sagging skin in the upper arms is treated with an incision from the underarm area extending along the inside or back of the upper arm. Additional incisions on the arms may be necessary anywhere excess skin has formed sagging pockets.

The smoother, tighter contours that result from upper arm contouring are apparent almost immediately, although initially obscured by swelling and bruising. In addition, skin quality is dramatically improved in both appearance and texture.

Thigh Lift

Reshaping of the thighs is achieved through incisions in the groin that can extend downward to the knee along the inner portion of the thigh.

Improving contours of the outer thigh may require an incision extending from the groin around the hip. Through these incisions your plastic surgeon will tighten tissues for a smoother, better toned thigh.

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Important facts about the safety and risks of body contouring surgery

The decision to have body contouring surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

Possible risks of body contouring following major weight loss include:

  • Unfavorable scarring
  • Bleeding (hematoma)
  • Infection
  • Fluid accumulation
  • Poor wound healing
  • Skin loss
  • Blood clots
  • Numbness or other changes in skin sensation
  • Anesthesia risks
  • Skin discoloration and/or prolonged swelling
  • Fatty tissue found deep in the skin might die (fat necrosis)
  • Major wound separation
  • Asymmetry
  • Recurrent looseness of skin
  • Pain, which may persist
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Persistent swelling in the legs
  • Possibility of revisional surgery

Be sure to ask questions:

It’s very important to ask your plastic surgeon questions about your body contouring procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

My recovery

After your body contouring procedure is completed, dressings or bandages will be applied to the incisions. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow-up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery?
    • When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Be careful

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

The results will be long-lasting

The results of a body contouring following aggressive weight loss are visible almost immediately.

However, it may take as many as one to two years or more for the final results of all the recommended body contouring procedures to fully develop. Visible scars will remain, but the overall results are long lasting, provided that you maintain a stable weight and general fitness.

As your body ages, it is natural to lose some firmness. However, most of your initial improvement should be relatively permanent.

How much will body contouring surgery cost?

Cost is always a consideration in elective surgery. Prices for body contouring procedures can vary widely.

A surgeon’s cost for body contouring procedures may vary based on his or her experience, the type of procedure used, as well as geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask.

Costs may include:

  • Surgeon’s fee
  • Hospital or surgical facility costs
  • Anesthesia fees
  • Prescriptions for medication
  • Post-surgery garments, and
  • Medical tests

Your satisfaction involves more than a fee

When choosing a plastic surgeon for body contouring surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Most health insurance does not cover cosmetic surgery or its complications.

Words to know

  • Areola: Pigmented skin surrounding the nipple.
  • Arm lift: A surgical procedure, also known as brachioplasty, to correct sagging of the upper arms.
  • Breast implants: Medical device placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants can be filled with either salt water (saline) or silicone (elastic gel).
  • Breast lift: Also known as mastopexy, surgery to lift the breasts.
  • Breast contouring: A surgical procedure following massive weight loss to improve shape and tone and remove excess fat and skin.
  • Circumferential incision: A surgical incision around the body to remove the “belt” of excess skin and fat and additional incisions that may resemble a bikini bottom pattern.
  • General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
  • Hematoma: Blood pooling beneath the skin.
  • Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
  • Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
  • Lower body lift: Surgical procedure to correct sagging of the abdomen, buttocks, groin and outer thighs.
  • Macerated skin: Excess skin that hangs and becomes wet or infected underneath.
  • Medial thigh lift: A surgical procedure to correct sagging of the inner thigh.
  • Outer thigh lift: A surgical procedure to correct sagging of the outer and mid-thigh.
  • Sutures: Stitches used by surgeons to hold skin and tissue together.

Questions to ask my plastic surgeon

Use this checklist as a guide during your consultation

  • Are you certified by the American Board of Plastic Surgery?
  • Were you trained specifically in the field of plastic surgery?
  • How many years of plastic surgery training have you had?
  • Do you have hospital privileges to perform this procedure?
    • If so, at which hospitals?
  • Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for this procedure?
  • What will be expected of me to get the best results?
  • Where and how will you perform my procedure?
  • What surgical technique is recommended for me?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • How can I expect to look over time? After pregnancy?
  • What are my options if I am dissatisfied with the cosmetic outcome of my procedure?
  • Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?