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

NIGHT AFTER SURGERY

Temporary bruising, swelling and numbness are common the first night after surgery.  You may need to go to the bathroom frequently during the night because of the IV fluids you were given during your surgery. Drink a lot of fluids in order to keep up with this fluid loss. As your body begins to balance itself out, it will rid itself of this extra “water weight and everything will return back to normal. No ice after the surgery.. cool compresses only. Patient will be ready to be seen socially within a week. It is usually apparent how much of the injected fat will last within 3 months.

ONE DAY AFTER SURGERY

The next morning following your surgery, you will return to Dr Motykie’s office for your first post-operative visit. You should leave all bandages and dressings intact overnight and until you reach the office the following morning.  Upon arrival to the office you will be escorted to a private examination room where your dressings will be changed and 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 one week after surgery.

You may feel tired and sore for several days following the surgery.  Your face will be swollen and tender after surgery but most patients say they are more tender at their donor site than in their face.  Aerobic and impact cardio exercise should be avoided for one to two weeks post-operatively in order to allow maximum survival of the fat grafting material. The resumption of and amount of physical /athletic activity should be guided by your own level of discomfort with “pain” being your ultimate guide.

ONE WEEK AFTER SURGERY

The final results of your surgery will typically be obscured by swelling and bruising at one week after surgery. Your face will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn’t be severe. Any discomfort you do feel can be relieved with your prescribed medications but most patients say that the surgery is almost “painless.” Because there are no visible incisions one the face, patients can return to normal activities very quickly and resume showering the day after surgery and exercise within the first week. Most people can return to work after a few days and some after 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. In regards to an exercise program, the majority of patients are allowed to return to light, low impact cardiovascular exercise after the first week of recovery. However, patients should be cautious with excessive cardiovascular exercise in the fat burning range during the first week after surgery in order to give the fat its best chance to “take” and last long term.

  • Medications: Some continued swelling, bruising and discomfort are normal and they are typically controlled with your prescription pain medication. 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 surgery.
  • 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 few weeks after surgery. You will be able to return to more strenuous exercise/heavy lifting at 3-4 weeks after surgery.

ONE MONTH AFTER SURGERY

Throughout time beauty has always been associated with aesthetic balance of the facial features. When facial features are altered or out of balance due to aging or heredity, facial fat grafting can be used to add volume and change the contour of the face.   Fat grafting can restore, rejuvenate and improve facial features by enhancing the shape of the face while taking into consideration overall facial harmony and proportion. Fat grafting is very effective in eliminating hollowness of the lower eyelids that can create a tired appearance, softening of the frown lines between the eyebrows that can make a person look angry and adding volume to the lips in order to make them more voluptuous. The overall end result should be a younger, healthier and refreshed appearance of your face. By one month after surgery, you should already be back into your normal rhythm at work. Exercise and workout routines should also be back in full swing by this point in time and the majority of my patients are back to their regular workout routine within 2-3 weeks after their surgery. Over the next several months many of the benefits of your surgery will begin to materialize and you will begin to enjoy the transformation you have received from you fat grafting procedure.

LONG TERM RESULTS

Facial fat grafting will continue to increase in popularity over the next decade as more surgeons and patients realize its true potential in facial reshaping. I currently use facial fat grafting in place of extensive reconstructive facial surgery and temporary injectable fillers whenever it is feasible due to its reliable results and minimal risk to my patients. In my hands, I can use facial fat grafting to reshape a patient’s face without the need for scars or extensive downtime. I also frequently use facial fat grafting to enhance my surgical results of other common facial aesthetic procedures such as facelifts and rhinoplasties. There is certainly a learning curve to master effective harvesting, purifying and injecting of the fat grafting material so patients interested in having facial fat grafting should consider going to a surgeon that has a depth of experience in performing the procedure. Lastly, I strongly believe that the high content of stem cells contained within the fat grafting material can rejuvenate the facial skin from the inside out. Since fat grafting is indeed viable, living tissue and not simply an “artificial filler” it only makes sense that it would possess the ability to restore and revitalize the skin from under which it was placed during surgery.

To find out more about facial fat grafting please contact us at 310-246-2355

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