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: Projection Adjustment

Cosmetic Rhinoplasty Procedures: Projection AdjustmentNose projection is the distance that it protrudes outward from the juncture where it connects the upper lip to its tip. If the tip protrudes excessively, it can have a significant impact on the overall appearance of the nose.

Conversely, an under-projected nose appears too shallow and makes the nose appear too small in comparison to the other features of the face. A surgeon can trim away a portion of the cartilage at the nasal tip to reduce the projection of the nose.


Key Points

To increase the nose projection, the surgeon may separate and realign the cartilage. They will move it forward and suture into a desirable position. If there is insufficient cartilage in the nasal tip, the surgeon may use a cartilage graft to build it up.

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


Correcting an Over Projected Nose

People who have over projected noses that are too protuberant from their face can consider corrective cosmetic surgery involving trimming away the nasal cartilage at the tip. In this procedure, the surgeon moves the nasal tip back to create a more desirable appearance. This is called nasal de-projection or retro-displacement.


Treating an Under Projected Nose

Re-projection of a nose which is under-projected involves lengthening the nose cartilage. There are two surgical approaches to achieve this depending on the nasal structure. One technique involves shaving the nose cartilage and suturing it up again to achieve a better nasal projection.

The second technique involves the surgeon sourcing a cartilage graft from another part of the body where there is adequate cartilage availability to use it to enhance the nose projection. The cartilage graft is usually taken from the nasal septum in primary rhinoplasty. The cartilage can also be taken from the ears or the ribs as well, if necessary.


Types of Cartilage Grafts

The location and method of cartilage graft use determine whether columellar struts are used to provide support to the columella which divides the nostrils. There may be an inadequate availability of septum cartilage if the patient is undergoing revision rhinoplasty. The surgeon will typically take the bone from the rib cage for the cartilage graft in such cases.  

The ear cartilage is believed to be advantageous in providing support to the nasal tip due to its elasticity. A common cartilage transplant from the ear will be denser compared to septum cartilage. But the results could be a nasal tip that feels more natural rather than one that is solid and rigid due to the elasticity.

If the patient needs cartilage for the primary rhinoplasty plastic surgery, the surgeon may also consider costal or rib cartilage as a feasible option. Septal or ear cartilage is generally used for nasal tip refinement. But at times, rib cartilage may also be used.


Considerations for Male Patients

Men considering nose tip refinement surgery may have concerns about the nose looking too feminine after the procedure. However, a skilled and experienced plastic surgeon can preserve the masculinity of the nose while simultaneously enhancing the nose projection.

A nose projection surgery can effectively enhance the nose shape while preserving its masculine attributes for men who not want to consider a full traditional rhinoplasty. 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: Projection Adjustment

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