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.

Rhinoplasty Revision

Rhinoplasty Revision Beverly Hills | Los Angeles

Rhinoplasty RevisionA successful rhinoplasty surgery should be aimed at achieving the best possible nasal shape, maximizing breathing and minimizing possible complications. Unfortunately, sometimes the results from a prior rhinoplasty can be unsatisfactory due to the surgeon’s inexperience, poor surgical technique or scarring of the nose after surgery. In fact, rhinoplasty has one of the highest reoperation rates of all plastic surgery procedures because nasal anatomy is inherently variable, the final results can be compromised by scar tissue formation and/or structural warping and the surgery itself takes artistic talent to perform successfully.

Some of the most common complaints after a prior unsuccessful rhinoplasty are a nose that is crooked, large, asymmetrical, bulbous, droopy or overall worse looking than before the surgery.  Nasal airway obstruction or worsening of initial breathing can also sometimes occur after primary rhinoplasty if the airway was not properly evaluated and treated during surgery. These types of results can be due to inexperience of the operating surgeon, under-correction or warping of the underlying nasal framework, over or under cartilage grafting of the nose, under or over resection of the nasal structural cartilages or poor communication between the patient and surgeon.

Revision rhinoplasty is a surgical procedure which corrects nasal problems of an aesthetic or functional nature resulting from a previous rhinoplasty surgery. Revision rhinoplasty is by far one of the most challenging to perform since it requires a plastic surgeon with experience and skill in reconstructing the cartilages and bony framework of the nose. Revision rhinoplasty may correct or improve a number of issues which have resulted from prior surgery including nasal obstructions and other functional problems which may inhibit breathing, cause depressions, bumps, collapsed or pinched tips and/or excessive scarring. In some cases, cartilage grafts or implants may be necessary to replace missing structures.  Revision rhinoplasty is more difficult to perform than primary rhinoplasty because the normal anatomy of the nose has been distorted, there are missing pieces of cartilage and there may be scar tissue formation inside of the nose. In addition, some patients are damaged emotionally since they are frightened that additional surgery may bring then additional problems or worse deformities. There are some certain ways to try and avoid these types of problems from recurring or happening in the first place which include making sure that your surgeon has a lot of experience performing rhinoplasty surgery, you are able to review their previous work, they spend a lot of time determining what type of nose you would like from surgery and they provide you with a computer image of what your nose could possibly look like after surgery. Most important of all is to remember that revision rhinoplasty is one of the most challenging plastic surgery procedures to perform since it requires a highly skilled plastic surgeon that possess both a strong aesthetic sense and a deep breadth of experience to perform successfully on a consistent basis. So be sure to do your homework and take the extra time necessary to research and find the right plastic surgeon to perform your revision rhinoplasty procedure.

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CONSULTATION

There are as many different shapes and sizes of noses that can result from rhinoplasty surgery as there are shapes and sizes before rhinoplasty surgery. Unfortunately, we have all seen the “operated-on’ looking noses that give away the fact that someone has had a rhinoplasty surgery.  These sorts of results should be avoided at all costs and you should be wary of any surgeon that displays or suggests results from rhinoplasty that give you an artificial or “over-done” look to your nose. Dr Motykie has coined these types of noses to avoid as the three “P’s” of rhinoplasty because they can be very difficult to correct surgically: the “Piggy”, “Puggy” and “Pinchy” nose. In other words, Dr Motykie recommends all of his patients to vehemently avoid noses after rhinoplasty that look turned up like a pig, smashed in like a pug dog or pinched in like a witch since they look very unnatural after surgery and they can be very difficult to correct.

Due to the vast breadth of techniques, philosophies, skill sets and professional backgrounds involved in performing modern day rhinoplasty, a diverse array of surgical results can be seen across the board. Patients seeking revision rhinoplasty may present with any number of functional and/or cosmetic complaints that will require a precise evaluation in order to offer any hope of adequate correction. The most common reasons for a revision rhinoplasty include a pollybeak deformity, nasal tip contour deformities, pinched tip, dropped tip, upturned tip, residual dorsal hump, crooked nose, hanging or retracted columella, flared nostrils, uneven nostrils, wide nose, runny nose and breathing problems. Also, remember the most dreaded and common stigmata of an “over-operated nose” that must be avoided in a primary or revision rhinoplasty surgery are the piggy, puggy and pinchy nose.

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During your consultation, Dr Motykie will address your desires from revision rhinoplasty surgery and he will give you a clearer understanding of how the surgery may best be able to meet your own needs and expectations.  Dr Motykie will also give you an opportunity to ask him any question you may have about revision rhinoplasty surgery as well as its possible benefits in your particular case. When going into your consultation, it is wise to come with questions written down and have a general understanding of the overall procedure so you can be prepared to learn as much as possible during your visit with Dr Motykie. Sometime during your consultation Dr Motykie may have you look through a book that contains numerous photographs of different results from rhinoplasty surgery in order to help you determine what type of nose you personally find attractive as well as which rhinoplasty technique may best help you to achieve your desired outcome from surgery. You are also encouraged to bring in photographs you may have obtained on your own from magazines or various internet websites which show the desired “look” you would like to achieve from surgery. Dr Motykie has found that looking through these types of photographs as well as reviewing his personal surgery portfolio are very helpful in determining what type of nose you personally find attractive.

Because a revision rhinoplasty procedure is very dependent on the artistic eye of the surgeon, Dr Motykie offers computer imaging to all of his patients so that they can see what their nose might look like after surgery even before undergoing any surgical procedure. Computer Imaging allows both you and Dr Motykie to communicate about your possible result from surgery and make adjustments to your surgical plan prior to actually having surgery. Utilizing a computer imaging system, Dr Motykie can clearly define the present problems you have with your nose as well as show you a realistic view of what can be accomplished surgically to create your new nose.  For a talented, artistic surgeon, this mental transformation is intuitive and based on natural ability. The true skill of the plastic surgeon is to then transform this computer generated image into reality. If you desire to have a Virtual Consultation, Dr Motykie will take several photographs of your nose in order to generate computerized versions of your possible results from surgery. If you live somewhere else in the world like many of Dr Motykie’s patients and you are unable to have a consultation with Dr Motykie in person, Dr Motykie can also perform a online consultation of your revision rhinoplasty procedure by emailing him photographs of your nose for computer imaging.

You should leave your consultation with a preliminary game plan for your surgery.  Cost is always a consideration in elective surgery. At the conclusion of your consultation you will have the opportunity to meet with Dr Motykie’s surgical consultant who will be able to explain to you the possible cost and timing of your revision rhinoplasty procedure. Cost may include surgeon’s fee, surgical facility costs, anesthesia fees, prescription medications, post-surgery garments, and medical screening tests. Dr Motykie’s consultant will also be able to explain to you all of your possible financing options. Remember, a surgeon’s price for surgery will vary based on their experience, the type of procedure being performed as well as the geographic location of their office. Please do not bargain shop for your plastic surgery but also make sure that you are not overpaying for your procedure by doing your homework, online research and obtaining several opinions from different board certified plastic surgeons before making your final decision about having your own revision rhinoplasty procedure.

For your own personal and confidential consultation, contact Dr. Motykie’s office today. Dr Motykie will answer all of your questions and together you can determine which procedure best fits your desires and needs. Remember, it is impossible for a surgeon to tell you the best approach for you without first listening to your desires and concerns and then performing a physical examination of your nose and surrounding facial structures. Out of town patients may send photographs in order to have a online consultation performed by Dr Motykie.

To find out more about nose surgery please contact us at 310-246-2355