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


Dr Motykie performs a closed rhinoplasty that is “scarless” and so gentle that most of his patients do not require nasal packing and almost no prescription pain medication after the surgery. You can expect your face to look and feel puffy for the first twenty-four hours after surgery. During this time, the nose may ache and you may also experience a dull, mild headache. It’s recommended that you remain in bed with your head elevated during the first day after surgery. Any discomfort can be controlled with your prescription pain medication and 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. You should leave your splint and any dressings in place overnight and there may be some mild bleeding from inside your nose throughout the night which is completely normal.


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 nose will be evaluated. After your examination, you will be allowed to return back to your home. You face will most likely be bruised and swollen and it is therefore best to keep your head elevated for the first few days after surgery. The first day after surgery there will be swelling and bruising around your eyes and you should expect this to diminish over the first week after surgery. You can apply cold compresses to the eyes to decrease swelling and increase comfort for the first 48 hours of surgery. You’ll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days.  In the unlikely event that you have nasal packing, it will be removed the day following surgery. A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. You will be asked to leave the nasal splint in place and refrain from blowing your nose for the first week after surgery.   If fat grafting was performed along with your facelift do not apply ice to your face because it can cause damage to the fragile grafted fat. At this appointment, all of your questions will be answered and you will be given instructions for the following week.

  • Dressings: You will apply antibiotic ointment to your incision lines once a day. There are no other dressings to change.
  • 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. You should begin you prescription antibiotics the morning following surgery and continue them for one week after surgery. A combination of Arnica Montana and Bromelain are encouraged after surgery in order to promote your healing process.
  • Surgical Garments: You will most likely have a neck compression wrap for the first week after surgery. You can remove this wrap in order to shower.
  • Bathing: Showering and bathing are permitted the very next day after surgery which requires removal of your compression garments.
  • 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.   Swelling and bruising, particularly around the eyes, are common and may increase during the first two or three days after surgery. Applying cold compresses can help to minimize the swelling. Most patients are moving around and feeling pretty good within about two days after surgery. Most rhinoplasty patients are up and about within a day or two and able to return to school or a desk-type job within a week or so following surgery.


For the first week after surgery, the results of your surgery will typically be obscured by swelling and bruising. Any discomfort you feel can be relieved with your prescribed medications but most patients say that rhinoplasty surgery is almost “painless.” Most people return to work one week after surgery. 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. The majority of patients are allowed to return to light, low impact cardiovascular exercise after the first week of recovery. Day by day, your nose will begin to look better and within a week or two, you’ll no longer look as if you’ve just had surgery. Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip of the nose. After removal of the splint, the nose may swell more for a few days. This is not the final shape of your nose and it will continue to improve daily after the surgery. You may feel stuffiness in your nose and sinuses which can be improved with antihistamines such as Benadryl or Claritin. Within about two weeks, most of the swelling and bruising should disappear, although some subtle swelling will remain for several months.

During this time, it’s also important to avoid hitting the nose and washing the face too vigorously. Try not to blow your nose for a week or so until the tissues heal. After about two days, you should feel well enough to move around your home. If you use contact lenses, you can wear them right away. However, because eyeglasses rest on your nose, once the splint is off you should not wear glasses unless they are very light and do not cause any pain while resting on the nose.  Avoid strenuous activity (jogging, swimming, bending) for two to three weeks.

  • Dressings: During this appointment, your nasal splint will be removed from your nose. All sutures used during the surgery are dissolvable, placed inside your nose and they do not need to be removed from inside the nose. 
  • Medications: Some continued swelling, bruising and discomfort are normal and they are typically controlled with your prescription pain medication. 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. Avoid smoking and alcohol for 2 weeks after surgery.
  • Bathing: You may bath and shower freely during the second week after surgery.
  • Activity: You will most likely be able to return to work within a week after surgery depending on your job.  Aerobic and impact cardio exercise should be avoided for one to two weeks post-operatively. Weight lifting should be avoided for 3-4 weeks post-operatively. The resumption of and amount of physical/athletic activity should be guided by the level of patient discomfort with “pain” being the ultimate guide. Avoid direct sun exposure/tanning of any bruising after the surgery.


Ensuring minimal downtime after rhinoplasty surgery comes with being careful and meticulous during the surgical procedure, therefore Dr Motykie performs the most advanced and least invasive version of rhinoplasty currently available. Bruising and swelling are also kept to a minimum which means you’ll be back on your feet in no time, leaving your friends and family guessing at why you look so good!  However, your new nose will take some time to be completely healed. Some subtle swelling may be present for months, especially in the tip of the nose. The final results of rhinoplasty may not be apparent for a year or more.

Depending on the amount of physical exertion required to perform your expected duties, you should already be back into your normal rhythm at work. Exercise and workout routines may begin at this point in your recovery process with pain as your ultimate guide.  When you return to the 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.  Although exercising will not adversely affect your end result, it may temporarily cause more swelling immediately after the exercise that will subside over the next few hours. The majority of my rhinoplasty patients are back to their regular workout routine within 3-4 weeks after their surgery.


Rhinoplasty is a powerful surgery that can yield immense patient satisfaction when the desired results are achieved from surgery. A successful surgery can change one’s personality form shy and withdrawn to exuberant and outgoing. Your nose will continue to heal for many months and the final result may not be evident for up to 6-12 months after surgery. If you are pleased with your early result from surgery, you will most likely begin to like your nose more and more as it continues to improve in shape and become more defined with time.  After a rhinoplasty surgery, you should look like a better version of yourself rather than someone completely different and your friends and family may begin to comment that you “look good.”  Others may comment on your eyes and ask if you have lost weight and it will be up to you as to whether you want to disclose you own personal secret to increased beauty and facial harmony.

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

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