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.

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Cosmetic Rhinoplasty Procedures: Tip Rotation and Reduction

Cosmetic Rhinoplasty Procedures: Tip Rotation and ReductionThe lack of proper rotation in the nasal tip means that the tip either lacks definition or is overly defined. Rotation is the upward or downward turn of the tip of the nose.

The surgeon will correct the nasal tip by cartilage reshaping. They will pay close attention to the nose base during this cosmetic surgery as it affects the tension and rotation.

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

 

What is Nose Tip Rhinoplasty?

Any surgery performed on the lower third portion of the nose is known as nasal tip rhinoplasty. This is an intricate plastic surgery procedure. The nose surgeon should be highly-skilled and experienced and have an in-depth understanding of the nose structure and how the cartilage and other tissue impact the process of nose refinement.

Nasal tip refinement is not necessarily a cosmetic surgery. In some cases, it may be a medical requirement. For example, sometimes the patient may have breathing problems because of an abnormally-shaped nasal tip either in their daily life or while sleeping (leading to breathing obstructions, and snoring among other issues).

An abnormal nasal tip can also cause a sinus infection. At times, patients may experience speech impediments due to the abnormal shape of their nose tip.

 

Need for Tip Refinement

Patients seek tip refinement for multiple reasons. But it is typically undertaken to correct a fuller or “bulbous” nasal tip.

Certain patients may be unhappy about their natural nose structure, especially patients with noses that droop at the tip, “hooked” noses, or upturned noses.

A tip refinement surgery can impact the overall nasal and facial appearance. These procedures typically help develop a slimming look.

 

Wide Tip Correction

A wide or bulbous nose usually occurs due to a combination of large nasal domes that are spaced widely apart and thick nose skin. The nasal domes refer to the tip defining points of the tip cartilage. A thick ligament or fat separates the nasal domes in many cases.

The nose surgeon will work on the soft tissue and shift the domes closer to address this condition. For patients with thick skin, the surgeon may place the graft on the nasal tip itself. This technique offers a better definition to the nasal tip.

The nasal tip can be made narrow by shaving off or tweaking the cartilage structure underneath the skin as well.

 

Less Invasive Procedure

The nasal tip refinement surgery is much less invasive than a full nose reshaping procedure. A typical nose surgery involves significant modification of the inner nose structure. This may involve fracturing the bones of the nose which will increase the recovery period.

However, tip refinement typically involves two to three incisions to allow the surgeon to access the underlying cartilage in that site. The surgeon will close the incisions after reshaping the nose. The recovery duration following tip refinement surgery is comparatively short.

A tip refinement surgery can be a suitable alternative to a “complete” rhinoplasty surgery if it is appropriate for the patient’s unique anatomical requirements. 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: Tip Rotation and Reduction

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