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.

Post-Operative

ONE DAY AFTER SURGERY

The next morning following your surgery, you will return to Dr Motykie’s office for your first post-operative visit.  Upon arrival to the office you will be escorted to a private examination room where your operative sites will be evaluated. After your examination, you will be allowed to return back to your home. All of your questions will be answered and you will be given instructions for the following week.

  • Diet: Mostly patients start with a liquid diet the night after surgery. Usually by the next day most patients are back to a normal diet.
  • Medications: Some swelling, bruising and discomfort are normal immediately following surgery and it is typically controlled with your prescription pain medication. Do not take any other pain medication including Tylenol, aspirin or ibuprofen in combination with your pain medications unless you are given permission by Dr Motykie. A combination of Arnica Montana and Bromelain are encouraged after surgery in order to promote your healing process.
  • Bathing: Showering and bathing are permitted the very next day after surgery.
  • Activity: Light activity is allowed and encouraged including moving about your house and going for walks outside in order to aid the circulation in your lower extremities. However, no heavy lifting or strenuous activity should be attempted during your first week of recovery.  You can usually return to a desk-type job within 72 hours, physical exercise generally can be resumed three weeks after surgery. Aerobic and impact cardio exercise should be avoided for one to two weeks post-operatively.

ONE WEEK AFTER SURGERY

The swelling is minimal and unnoticeable within one week. Most chin augmentation patients describe a “tight” feeling in their chin the week after surgery but rarely are pain an issue. You will be provided with pain medications should you need them although I find it is rarely needed. It is common to have some difficulty smiling and talking normally for several days after surgery. If you have intra-oral sutures, you may be asked to eat a softer diet for several days after surgery. The results of your surgery will typically be obscured by swelling and bruising at one week after surgery. Most people can return to work after a few days and resume exercise within one week. Most patients can drive their vehicles within a few days after surgery, but plan on having someone drive you to your first few post-operative visits anyway.

  • Medications: Some continued swelling, bruising and discomfort are normal and they are typically controlled with your prescription pain medication and muscle relaxants. You should also be finishing your prescription antibiotics at this time.  Arnica Montana and Bromelain may be continued for another week in order to promote your healing process.
  • Bathing: You may bath and shower freely during the second week after
  • Activity: Exercise of some sort is very important, even if it is just walking around your house. Having said this, rest is also important to the healing process and heavy lifting and strenuous activity are still restricted during the first month after surgery. The majority of patients are allowed to return to light, low impact cardiovascular exercise after the first week of recovery.  You will be able to return to more strenuous exercise/heavy lifting at 2-3 weeks after surgery.

ONE MONTH AFTER SURGERY

You should already be back into your normal rhythm at work. When you return to activity, start at half speed and increase to your normal routine as long as you do not feel any pain during and/or the day after your workout.  The majority of my chin augmentation patients are back to their regular workout routine within 3-4 weeks after their surgery. Over the next several months many of the benefits of your chin augmentation surgery will begin to materialize and you will begin to enjoy the transformation in your facial profile and expression.

LONG TERM RESULTS

All patients vary in their ability and speed to recovery after surgery but most commonly you can expect the final result from surgery to be evident at a few months after surgery.  Most patients state that friends and family did not necessarily notice their chin was augmented, but rather they are often asked if they “lost weight” since their neckline was improved along with the chin augmentation. People also notice that people stop asking them if they are upset or angry because their facial expression has become more balanced and pleasant after the surgery.

REVISION CHIN AUGMENTATION SURGERY

Sometimes a chin augmentation performed elsewhere does not produce the final result a patient initially desired form surgery.  The chin implant placed during surgery may have been too big, too small, folded over or not shaped properly. In addition, the implant may have been placed in a poorly formed pocket that could be too high, too low or asymmetrically placed which can lead to a crooked or misshapen chin. When this occurs, a revision chin augmentation procedure can be performed in which the misplaced or misshapen chin implant can be removed and replaced with a more suitable implant that is properly placed in a symmetrically created pocket.

COMBINED PROCEDURES

Because a chin augmentation primarily deals with balancing the profile view of a patient, all of the remaining features that make-up the profile must also be taken into consideration. Of the features that are contained in the profile view, the chin and the nose are the two most prominent and the ones that need to brought into balance in order to obtain facial harmony and a beautiful profile view.  Because the size of the chin may magnify or minimize the actual perceived size of the nose, many plastic surgeons may recommend chin surgery to a patient having nose surgery and vice versa.  In fact, about 15% of patients having a rhinoplasty will also receive a chin augmentation in order to balance their profile.

Sometimes the chin augmentation is combined with liposuction of the neck or a necklift procedure for a particularly dramatic improvement and rejuvenation of the jawline.  In women the neckline is made more long and elegant and in men a more athletic and younger look is achieved.  When the neckline is contoured along with the chin, the overall look is not only more balanced and beautiful; it is also more youthful and healthy.

To find out more about Chin Impalnts please contact us at 310-246-2355

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