Art, beauty, happiness. These are the objectives that board-certified dermatologist Maritza Perez, MD, FAAD aims for as a dermatologist in terms of results for her patients, and for her own sense of satisfaction. As a Mohs Micrographic surgeon, she works to rid patients of skin cancers while achieving the best cosmetic results possible. Aside from Mohs surgery, Dr. Perez specializes in laser and cosmetic surgery. She is also the Associate Professor of Clinical Dermatology at Columbia University, in New York City, and an active member in numerous dermatology organizations, such as the American Society for Dermatologic Surgery, American Society for Laser in Surgery and Medicine, American Academy Dermatology Women Association, Dermatology Foundation, and is on the Board of Directors for the Skin Cancer Foundation.
As much as she tries to keep people skin-happy, the most important is to make people happy. “I love what I do because I help people,” Dr. Perez says.
Tell us a bit about your background. How did you come to choose dermatology as your specialty?
During my pathology block at the beginning of my second year of medical school, I developed gastrirtis and was out of school for one week. I read the whole pathology book on my own and was fascinated with immunology. I found out that the shortest way into immunology was through dermatology and I decided that was my destiny.
We understand that one of your key interests is skin of color. What is the difference in the way that darker and lighter skin tones age?
There are many differences between skin of color and Caucasian skin: the number of structures of melanosomes within melanocytes, the distribution of melanosomes within keratynocytes, the presence of reactive fibroblast that lead into keloid formation, and and many more. But what is the most important concept for patient care is that skin of color responds to inflammation with hyperpigmentation and this post-inflammatory hyperpigmentation can be permanent. Therefore one needs to know how to treat and manage clinical conditions with surgical interventions and their complications to effectively treat patients of color.
What are some of the challenges of being a Mohs surgeon?
As a Mohs surgeon, every day is a challenge. You start the day not knowing how many stages the removal of the skin cancer you are treating is going to take. You do not know how you are going to repair the wound until the skin cancer is totally removed. How the wound is going to heal and if the patient ultimately is going to be satisfied with the results. There are multiple levels of challenges in the life of a Mohs surgeon, but that is the beauty of it.
New and better lasers are constantly be introduced. What technology do you find particularly useful or exciting?
Although new laser technologies has emerged, it does not mean that established effective and safe technologies should be replaced. I think that every laser surgeon should adhere to the effective and safe treatments they have used while investigating new technologies of the future and make sure they are effective and safe to add to their armamentarium.
How have fillers changed over the years?
The field of cosmetic dermatology have been blessed by the rapid development of new solutions for rejuvenation. Among the most rapidly developing field is the field of facial volumization with fillers. From bovine collagen to human collagen, both not as exciting today in the advent of fillers with hyaluronic acids, L-polylactic acid, calcium hydroxyapatite, fat transplantation, and others, the science of volumizing the face is fascinating. Understanding how to effectively and safely replace the volume of the face in every patient you treat and doing it on an individual basis is an art. In my practice I use all of them for different indications with very successful results. One of the most important factors to consider is that the filler not only is going to volumize by expanding the tissue but also by inducing your own fibroblasts to produce collagen.
Hence the durability of some products. For example the effect of fat transplantation can last as long as 10 yeras while the volumization with calcium hydroxyapatite and L-polylactic acid can last from 18 months to up to 2 years.
Why do you love what you do?
I love what I do because I help people. I cure them from their skin cancers. I reconstruct their Mohs defects to the best of my ability with the result in the best cosmetic outcome. I treat many of their maladies effectively and safely with lasers. And ultimately, I like to beautify my patients consistently with the art of fillers and chemodenervation. I make most people happy.