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.

Breast Implant Pocket Placement

Breast Implants | Breast Augmentation Beverly Hills | Los Angeles

A breast implant can be placed in three primary pocket locations: subglandular (underneath the breast mound and above the chest muscle), submuscular (underneath the chest muscle) and partial submuscular/dual plane (partially underneath the breast mound and partially underneath the chest muscle). There is no ideal implant pocket placement, but there are certain advantages and disadvantages to having the breast implant placed in the different pocket locations.

Subglandular Placement: The major advantage of subglandular implant (i.e., above the muscle or underneath the breast mound) placement is less post-operative tenderness/recovery since the chest muscles are not involved in the surgery.  However, some major disadvantages include increased risk of implant rippling and palpability in women with thin breast tissue since subglandular placement offers less coverage of the implant as well as an increased risk of developing capsular contracture. Also, subglandular placement of the implant often leads to a more fake appearance of the breast since the roundness and projection of the implant is more evident visually than when the implant is placed underneath the muscle.  Lastly, some surgeons feel that subglandular placement of breast implants helps to lift and reshape the breast mound more than submuscular placement in some cases.

Submuscular Placement: Although all early breast augmentations were performed by placement of silicone gel-filled breast implants in a subglandular (above the muscle) pocket, it was noted that sometimes the breasts began to appear slightly unnatural due to implant rippling, palpability and capsular contracture (scar tissue formation). Therefore, the submuscular (under the muscle) breast augmentation technique was developed to help lower the incidence of capsular contracture, provide a more natural breast mound appearance and decrease implant visibility, palpability and rippling due to improved implant coverage/camouflage. The disadvantages of submuscular placement were a possibly longer recovery period, increased post-operative tenderness due to partial release of chest muscle and sometimes a “high-riding “placement of the implant within the chest pocket. The dual plane approach to breast augmentation was developed to help address this last disadvantage and to help improve the overall shape of the submuscular breast pocket by allowing the breast implant to settle into the lower breast fold more naturally (see below).

Dual Plane (partially below and partially above the chest muscle): The dual plane breast augmentation is the most contemporary breast augmentation technique currently being performed today. As stated above, this technique was developed as patients and surgeons began to notice that purely submuscular placed breast implants tended to shift upward and laterally (towards the armpits) over time.  The solution was to release the chest muscle attachments at the lower pole of the breast in order to relieve the upward and lateral forces of these muscles on the breast implant. Therefore, in this technique the upper half of the breast implants remains covered by the chest muscle (submuscular) while the lower half of the implant  is allowed to settle underneath the breast mound (subglandular) in the lower pole of the breast near the breast fold (i.e. dual plane/pocket). In this way, the high-riding look of the purely submuscular approach is avoided and the breast implant sits in a more natural position in the breast pocket. This technique can also help to lift the areola to a higher position on the breast mound as well as prevent constrictions of the lower pole of the breast that can cause such problems as creation of a double bubble deformity. In addition, there is no need to try and push the breast implants down into the lower pole of the breast after surgery since breast implant settling occurs more naturally and almost immediately after surgery with the dual plane technique.

To find out more about breast augmentation please contact us at 310-246-2355

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