Making Happy Endings

Drs. Ergun Kocak and Pankaj Tiwari

Dr. Pankaj Tiwari and I met eight years ago at The Ohio State Medical School, where we both served as Assistant Professors and Attending Surgeons in the Department of Plastic Surgery. In 2013 we founded Midwest Breast and Aesthetic Surgery in order to provide patients easier access to a full range of plastic and reconstructive procedures, including DIEP Flap surgery. Our path has been an interesting one. After medical school (I attended The Ohio State University College of Medicine and Pankaj attended the School of Medicine at New York University), we completed plastic surgery residencies (I continued on at The Ohio State University and Dr. Tiwari went to the Baylor College of Medicine). By mere coincidence, we both continued on to complete our Fellowship Training at the MD Anderson Cancer Center in Houston. We missed each other at MD Anderson by two years! Upon completing my fellowship, I returned to The Ohio State University College of Medicine, where Pankaj and I worked side-by-side as faculty members in the Department of Plastic Surgery. The rest isn’t just history, it’s karma.

Dr. Tiwari and I, before we met each other, chose advanced microvascular and complex reconstructive surgery as our specialties. What is that- what do we do? Simply put, we help bring happy endings to breast cancer patients who are on a very difficult journey. And we do this from our hearts, inspired by both our Moms, who had breast cancer.

There are basically two types of reconstruction surgeries that are performed after mastectomy: 1) inserting an implant that’s filled with salt water, silicone gel or a combination of both and 2) “flap” reconstruction. Flap reconstruction, such as the DIEP Flap technique, is the most advanced form of breast reconstruction surgery available today. "DIEP Flap" surgery uses a patient's own abdominal skin and fat to reconstruct a natural, warm and soft breast after mastectomy. Because little to no muscle is used, DIEP Flap surgery offers a quicker surgical recovery and reduces the chance for complications. A side benefit of the DIEP Flap procedure is a patient’s tummy will be tighter and flatter…as if she had a tummy tuck.

Our goal with DIEP Flap surgery is to reduce the time a patient spends in surgery, minimize any problems after surgery, and improve surgical outcomes. To achieve this, we use a "dual surgeon" approach for each DIEP Flap procedure; two specialty-trained microsurgeons work together on every surgical case. Pankaj and I also correct or “re-do” prior breast reconstructions for patients who did not end up with the result they had hoped for. This is fairly common, and the need for revision does not necessarily represent a failure of any prior reconstructive surgery…it is a refinement.

I would like to mention “Janet’s Law,” also known as the Women’s Health and Cancer Rights Act (WHCRA), which helps protect many women with breast cancer who choose to have their breasts rebuilt (reconstructed) after a mastectomy. This federal law requires most group insurance plans that cover mastectomies to also cover breast reconstruction. It was signed into law on October 21, 1998. Janet’s Law was named after Janet Franquet, a young mother and a nurse, who was denied reconstructive surgery after her mastectomy, in 1997. Janet was a champion for insurance coverage for breast reconstruction after mastectomy based upon medical necessity, not cosmetic reasons.

Dr. Tiwari and I perform advanced breast reconstruction surgery, including DIEP flap, at Ohio Valley Surgical Hospital in downtown Springfield. Their outstanding surgical and medical team is why we drive an hour west from Columbus to work here in Springfield. We have a dedicated surgical team at Ohio Valley that has previous experience in specialized surgical procedures and have received special training in advanced breast reconstruction. Everyone at Ohio Valley makes it easy for us to take care of our patients. Another compelling reason that attracted us to Ohio Valley is the exceptional breast surgeons and other plastic surgeons who practice here. These surgeons and the hospital staff….they provide an environment of excellence and compassion for patients, who trust the whole process. Dr. Tiwari or I stay in Springfield after each surgery, to be immediately available for our patients, if necessary.

Women going through the journey which is breast cancer always have choices. At Ohio Valley Surgical Hospital, many breast reconstruction options are available, including complex and advanced breast techniques such as DIEP flap… all close to home. For questions about DIEP flap and advanced breast reconstruction, please don’t hesitate to call me or Dr. Tiwari at 1-855-687-6227. We also welcome your emails- just visit our website at

Drs. Ergun Kocak and Pankaj Tiwari are Board Certified in Plastic Surgery and Fellowship Trained in Microvascular Reconstruction. To learn more about Drs. Kocak and Tiwari, and their colleague, Dr. Bianca Chin, visit or call 1-855-687-6227.