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.


Cosmetic Rhinoplasty Procedures: Nasolabial Angle Adjustment

Cosmetic Rhinoplasty Procedures: Nasolabial Angle AdjustmentTwo lines make up the nasolabial angle as part of the nose anatomy. The first line extends from the nasal tip to the area above the upper lip.

The second one runs from the upper lip to the nose base, where the nostrils bifurcate. The nose tip rotation and nose projection can affect the degree of this angle.

In a majority of cases, the surgeon will try to create a 90 to 95-degree nasolabial angle in men and a 100 to 105-degree angle in women. They can refine this angle through a combination of various rotation adjustment and projection techniques.

Board certified plastic surgeon Dr. Gary Motykie provides rhinoplasty to patients in Beverly Hills, West Hollywood, Los Angeles, and surrounding locations.


Correcting Nose to Lip Angle and Bulbous Tip

To correct a bulbous nose tip, the surgeon may use a full delivery technique. This involves suturing the dome to the lower later cartilages while adding a cartilaginous strut graft for support, if necessary.

The surgeon can also correct wide and flared nostrils through alar-based reduction. Any type of acute angle to the lip can be corrected by raising the tip and reducing the caudal membranous and cartilaginous septum.

Other techniques to correct this condition involve reducing the anterior septal angle to allow upward tip rotation as well as techniques that change the tip itself or the tripod of the nose and provide length to the medial crus or columella to enable it to project upwards and rotate.

The surgeon may choose to shorten the gull wing or lateral aspect of the nose tip cartilages. They can use these approaches in combination to narrow the nasal tip and improve the columellar labial angle (CLA) at the same time. Finally, the surgeon can undertake the alar base excision along with a rhinoplasty and make the nose base narrower for width reduction.

Various techniques are available to correct the angle between the lip and the columella such as Caudal extension grafts and plumping grafts which can effectively project the nasolabial angle.

Creating proper tip rotation is a standard feature of rhinoplasty procedures. It is often used along with developing better nasal tip definition. But thicker skin causes limitation in creating better definition.

The surgeon may trim the septum at the anterior angle. However, the surgeon can recommend this specific technique to the patient only after an examination of the nose.


Lifting a Drooping Nose Tip

The nasal tip is often droopy in patients who have thick skin and heavy noses. Various techniques can effectively elevate the nose tip. The surgeon can reduce the length of the septum. But most heavy noses require extra tip support. The surgeon can use cartilage grafts to provide support to the nose tip as well as push it upwards.

The nasal septum is the ideal source of graft material if the patient has not undergone rhinoplasty in the past. The surgeon can also make the tip cartilages narrower. For patients with very thick skin that requires more support, the surgeon will typically use a graft comprising the patient’s own cartilage, called an extended shield graft.

Cosmetic surgeon Dr. Gary Motykie receives patients from Beverly Hills, West Hollywood, Los Angeles, and nearby areas for rhinoplasty.

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Cosmetic Rhinoplasty Procedures: Nasolabial Angle Adjustment

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