Physician Spotlight: Chérie M. Ditre, MD

Chérie M. Ditre, MD is the Director of the Skin Enhancement Center and an Associate Professor of Dermatology at University of Pennsylvania School of Medicine and Penn Medicine at Radnor, PA. She chatted with Practical Dermatology® magazine about the evolution of cosmetic dermatology from chasing lines to re-volumization, and also gave us a heads up on some exciting things to come.

What does today’s cosmetic dermatology patient want or expect?

“Today’s cosmetic dermatology patient is interested in safe and effective treatments to help them age gracefully by tightening and brightening the skin and by filling out, smoothing, and relaxing frown lines and wrinkles. Most patients don’t want to look like the Sur‘Real Housewives’, as I call them, with large, oversized lips and really big cheeks! They want to look good for their age and maybe even about five years younger but not 25 years younger as that is not realistic to them. They understand that today we are about revolumization of the face not overvolumizing lines or lips or cheeks. It’s about restructuring and lifting and volumizing without chasing lines. It is about using fillers that are safe and that can be reversed if they feel overfilled, and using Botulinum toxins like Botox, Dysport, or Xeomin that don’t make them appear frozen! It is about skin care products that work to retexturize, soften and smooth out lines and wrinkles as well as lighten and brighten their skin from unwanted brown age spots and tighten and firm the skin.”

What are some of the more popular technologies and devices you are using in your practice today?

“One of the most exciting new areas is with hyaluronic acid fillers, such as the Restylane Refyne and Defyne product line that ‘move with your skin.’ These new fillers have the capability to take care of those expression lines that appear either at rest and are more pronounced on smiling starting from the crows’ feet and connecting down into the cheeks that make one appear as if a rippling wrinkle effect occurs much like after a pebble is dropped in a lake. Another exciting device is the microneedling technique. Depending on the depth that is chosen, you can smooth out wrinkles like the perioral areas (bleeding lipstick lines) as well as old acne scars. I have seen patients who were scarred by laser improve after treatment with microneedling. It is quick and relatively painless.

Microblading for restoring the appearance of eyebrows is another creative and attractive newcomer that we will be hear a lot more about.”

Combinations are on trend (see more on this on page 46). What are some of your more popular cosmetic duos or trios?

“Most patients like the combination of retinoids and alpha hydroxyl acids with topical antioxidants for skin care as well as sunscreens that are tinted so that they don’t look ghostly wearing them. With regard to procedures, the winning combinations are the fillers to reshape, volumize, and lift the face as well as the botulinum toxins to relax those frown lines. Combinations involving microdermabrasion and chemical peels as well as infusion technologies like Dermasweep and OxyGeneo are attractive additives to the cosmetic arena.”

What do you recommend for post-procedure care?

“It really depends on what procedure you are doing. I love the Avene Thermale Spring water gel line that cools and soothes the skin after procedures that create heat, like lasers. In addition, they have a group of products for intolerant skin that works well. Vaniply ointment is paraben free, fragrance free and is great for those patients with allergies.”