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Dr Eithne Brenner, Unit E, Citywest Shopping Centre, Citywest Drive, Dublin, Dublin (2026)

20/12/2025

If you have had a dermal filler treatment and you don’t like it, can you just have it dissolved, wipe the slate clean and start again?
It’s not as simple as that. We know dermal fillers can last many more years than we previously thought. They can last a decade or more and that can be good if they’re well placed in subtle amounts, they’re giving you a result you like and we generally don’t dissolve these. However, if filler has been overdone, or looks unnatural, there is a prescription only injectable medicine called hyaluronidase which can help dissolve hyaluronic acid dermal filler. Not all injectables are hyaluronic acid and if it’s not hyaluronic acid this medicine won’t work. Some products are much easier to dissolve than others and some may take several sessions. If this dissolving treatment is used, you will lose the dermal filler, and some water that the filler has drawn to itself( which will have added some volume), time will have passed and you will have aged somewhat in the meantime, and there’s the original reason the treatment was done for, for example hollow under eyes or thin lips, which will return once the filler has been dissolved. The skin or soft tissues may have been stretched and may not bounce back fully. If somebody doesn’t have records of their treatment it may be very hard to know what type of filler material it is, or where the filler was placed; ultrasound can help but it won’t show all particles of filler and MRI can be helpful sometimes too. I am a fan of dermal fillers and they can give a positive result and can help restore lost volume and reduce some signs of aging.
My overriding advice is if you’re considering a dermal filler treatment, have it placed correctly and carefully in the first place by a medical professional who is highly experienced in aesthetic procedures such as an aesthetic doctor, dentist or nurse, have subtle, careful treatments, sit tight and go slowly and gently. Then dissolving shouldn’t be needed. Always ask to see the product being injected and take a photo or keep a copy for your own records. Eithne

19/12/2025

What are these little ‘bunny lines’ or scrunch lines?
And do we treat them with botulinum toxin? These are a normal part of our anatomy and unless they really bother somebody we just leave them alone.
There are two main muscles that contribute to these little bunny lines, the first is nasalis, that spreads out over the bridge of the nose. The upper part narrows the nostrils and the lower part widens them to allow more airflow in exercise. The second muscle is LLSAN ( levator labii superioris alequae nasi), it’s the longest muscle name in the body. This lifts the top lip and widens the nostrils. If we treat other areas with botulinum toxin, bunny lines can stand out and cause someone to ask for treatment. We don’t often treat them as we risk dropping the top lip and making the smile look unnatural.
In someone with a gummy smile we will target them deliberately to drop the top lip and to hide some of the excess gum show.
Bunny lines are a normal part of our anatomy so if they don’t bother someone, we leave them alone. In Ireland, botulinum toxin is a prescription only medicine and you must see a medical
doctor or dentist for a face to face assessment for suitability. Eithne

18/12/2025

What happens the crow’s feet lines as we age and what implication does this have if we’re considering botulinum toxin or anti-wrinkle treatment?
We start to develop small crow’s feet lines in our mid 20’s from repetitive expressions like smiling and blinking and from sun damage and we’re beginning to get some collagen loss. In this situation we would just recommend skin care, SPF, sun protection measures like sunglasses, and we generally wouldn’t treat with botulinum toxin. These lines are part of our natural smile and are an attractive part of our expression. Overtime then these lines will deepen and widen and extend further out along the cheek. We will consider using botulinum toxin or anti-wrinkle medications in this situation (if you’re medically suitable). It will improve but not fully correct all of these lines, because if we extend our treatment out too far or too low we risk hitting one of our smile muscles zygomaticus major. If we do this, we’ll drop the smile on the affected side and this can take months to wear off. So yes, it may still be well worth treating crow’s feet lines with toxin as we get older, as long as we recognise that the effect will be mild, and we need to look at other options too, like our skin care, SkinPen micro needling, maybe some skin booster injectables or collagen stimulators and also light or laser treatments can help too. In Ireland, botulinum toxin is a prescription only medicine and you must see a medical doctor or dentist for a face to face consultation to assess you for suitability. Eithne

17/12/2025

What happens if we put too much dermal filler in the nasolabial folds?
I’ve put some gauze under my gum to show what the effect would be of too much nasolabial filler.
This bulks out the area too much, it thins the lip and it lengthens the nose to lip area and it distorts the smile, widening it and making it look like a joker smile.
When I started doing aesthetic medicine injectables over 18 years ago, people routinely came in and asked for filler in the nasolabial folds, and we did it. Some people looked a bit better, but the overall harmony of the face was not improved. Thankfully our knowledge of anatomy and facial aging has improved so much, and now if we put any filler in the area, we go very carefully, putting in small amounts to get a subtle result.
Nasolabial folds are normal, even babies have them; here’s a picture of myself and my twin Mick at age 3, and we both have obvious nasolabial folds (he’s still a great hugger 🤗).
Too much filler in the nasolabial folds feels and looks heavy and makes me look like an extra from The Grinch movie- not a good look!!
As with all fillers, if we use them, they should be subtle, careful, small amounts. Being overfilled looks unnatural and fake.
All medical procedures have risks and benefits and these need a detailed discussion with a medial professional. Eithne

16/12/2025

If you have frown lines between the brows, why don’t we just inject a little bit of dermal filler to smooth out the lines?
This is because the blood vessel layout of the face is extremely complex, and there are important blood vessels directly under these creases which connect with the blood supply to the eye.
We always want to keep any treatments as safe as possible, and in the centre of the face especially, the blood vessels have less collateral or backup supply and are more vulnerable to damage. We always want to avoid getting any filler material into blood vessels to avoid blocking them, which could lead to damage to the skin, soft tissues or the eye itself.
We reduce risks with extensive anatomy knowledge and training, specialised techniques and ideally the use of ultrasound which helps me map the blood vessels.
The other reason is that the primary cause of these crease lines is the repetitive muscle contraction over years, and we might use the prescription only botulinum toxin to reduce the muscle activity, allowing the lines to soften out over time. In Ireland you must see a medial doctor or dentist for a face to face consultation to assess you for suitability for botulinum toxin.
We also look at skincare and skin treatments such as SkinPen micro needling to help reduce lines.
Never, never let an inexperienced injector treat your frown lines with dermal filler. All medical procedures have risks and benefits and these warrant a detailed consultation with a medical professional. Eithne

15/12/2025

We’ve had lots of questions about neck treatments. While I can’t answer individual queries, I’m very happy to do video topics, so please send in suggestions. The neck is a tricky area to address as the skin is thinner and drier and has few sebaceous glands. We don’t tend to apply our skin care products to the neck in the same way as we do the face, so by the time people come to see me often the skin on the neck has picked up a lot of sun damage and has become more lax and crepy, with loss of collagen, and with pigmentation and redness. The simplest thing to do is to look at your skin care; use an SPF every single day, add a vitamin C product, a moisturiser, and if you can manage to add retinol do it very, very slowly as the neck is less tolerant of active ingredients, especially retinol.
The next thing I would do is look at a course of SkinPen micro-needling to boost collagen and help reduce neck lines. I might consider skin boosters such as Profhilo or SkinVive. If we look at long term bio stimulator injectables, my top two are Radiesse and Juläine. Both need two or more treatments and results can then last up to two years or more. We might use laser or light treatments too. If there is a lot of pulldown from the platysma muscle or platysma bands ( think Deirdre Barlow from Coronation Street) and the corner of the mouth DAO muscle, we might use the prescription only medicine botulinum toxin. If the neck skin is very saggy and crepy with a lot of loose skin, then a surgical neck lift is an option.
I don’t do neck lift surgery, but I can refer to colleagues who do.
Very few people will consider surgery, but we have lots of nonsurgical options that can help too. Eithne

13/12/2025

Have you heard the term “peanut head” and how we might use it in aesthetic medicine?
Now, if one of my sons calls me peanut head, I’m going to assume it’s not a compliment, but we use this term in aesthetic medicine to describe the changes that happen the face over time.
The soft tissues tend to slide down as the underlying bone structure is shrinking and receding. Then we get the appearance of hills and valleys in the face, areas of volume loss and areas of sagging or heaviness and this looks like a peanut shell, hence the term “peanut head”.
It’s not used as a criticism, more an observation of the changes that are happening. When I draw a more sagging side and compare it to a more youthful contour on the other side, I can see the differences.
We like to see a smooth contour rather than those hills and valleys which signify aging to us, and to help restore some of the more youthful features, I might add back a little volume in areas where it’s lost, for example the temples, the cheeks (very gently), in front of the ears, along the jawline and in certain parts of the chin. This helps disguise some of the volume loss and some of the aging changes and restores some youthful features.
For this kind of treatment, I would use dermal fillers or collagen stimulators such as Juläine or HarmonyCa.
All aesthetic medicine procedures carry risks and benefits and these need a full discussion in a face-to-face consultation. Eithne

12/12/2025

Let’s chat through some things that botulinum toxin or anti-wrinkle medication can achieve, and things it can’t achieve.
It’s primarily a muscle treatment and it is very effective for reducing dynamic or movement lines that can cause creasing of the skin with repetitive movement over time. We use it to reduce some muscle movement if that skin creasing is making us look tired, angry or sad. We’re not using it to eradicate all expression or remove all movement- we need to communicate with one another and to look natural and not frozen.
What it can’t do is repair sun-damaged skin, prevent collagen loss, prevent thinning skin and sagging that happens with normal aging, it can’t lift sagging tissue or replace lost fat or changing bone structure.

It can’t obliterate the effects of smoking, sun exposure, alcohol, stress, sunbed use, etc
Before considering any treatment, look at your skincare, ideally use a broad spectrum SPF every day, and consider adding vitamin C and vitamin A/retinol products. Then if you want to consider having anti wrinkle treatment, see a medical doctor or dentist for a face to face assessment for suitability. Botulinum toxin is a prescription only medicine and like all medicines has risks and benefits that need individual discussion. It’s only one tool available to us and we have lots of options to help repair your skin and help you look refreshed but not unnatural. Eithne

11/12/2025

did a great post about the poor medical supplies on a recent Ryanair flight.
Airlines could and should do better; medical kits can be cheap and easy to replenish. They could be life-saving and they could help prevent a flight diversion. Here’s my medical kit that I carry with me everywhere- the contents are straightforward inexpensive and could be life-saving. Let me show you them.
I carry a stethoscope, some disposable gloves, some vomit bags, a blood glucose monitor, a blood oxygen monitor, and pen and paper. I have dispersible aspirin and a GTN spray that we would use in someone with chest pain where we suspect a heart attack, to help open up the heart blood vessels. I carry adrenaline for anaphylaxis ( severe allergy), an antihistamine, and some sugar gels in case of low blood sugar.
I personally carry Benzylpenicillin in case of meningitis.
(I keep a defibrillator and oxygen in my car, so I could access them at work but also out in the community. )
Flights usually carry a small oxygen cylinder.
The absolute ideal would be to have a defibrillator on every flight; they cost less than €1000 and the battery lasts 5 years.
Some airlines are better equipped than others, but like Niamh, my experience of Ryanair supplies is that they are poor and could be so much better. Eithne

10/12/2025

Most people are familiar with the traditional ‘three areas’ of botulinum toxin in the upper face, softening expression lines in the frown lines between the brows, the forehead and crows feet lines.
There are many situations where we might consider using it in the lower face, jawline and neck.
In Ireland, botulinum toxin is a prescription only medicine and you must see a medical doctor or dentist for a face-to-face consultation to assess you for suitability.
If you’re suitable and you wish to go ahead, we might use it along the jawline or in the neck to help reduce some of the pulldown from the platysma muscle. This helps to restore the contour of the jawline.
We also consider using it at the corner of the mouth in the depressor anguli oris (DAO) muscle which is pulling the corner of the mouth down and giving us a sad or tired or ‘down in the mouth’ appearance. We might use it in the masseter muscles at the jawline if they contribute to widening of the face or they’re causing teeth grinding or pain, and we might also use it to reduce a gummy smile where a lot of gum shows on smiling or we can help lift up the tip of the nose which droops overtime so it’s a very versatile medicine but you must be assessed for suitability. Every medical procedure has risks and benefits so these need to be discussed in detail. Eithne

08/12/2025

How do I achieve an eyebrow lift with botulinum toxin or anti-wrinkle medication?
If you’re medically suitable, we’re using this prescription only medication to reduce muscle activity in muscles that are pulling in the opposite direction to what we want to achieve.
So when I want to raise the eyebrows, I treat the muscles that are pulling the brows down and when these frowning muscles are more relaxed, the forehead muscles frontalis pull up more and help raise the brows.
I treat the muscle procerus that pulls the medial or inner brows down and causes horizontal lines across the bridge of the nose, and I treat the two corrugators which pull the brows down and inwards. Then I very lightly treat the upper outer parts of the orbicularis oculi muscle that closes the eye.
If I want to target forehead line I have to go very lightly, especially in 60 year olds like myself as we especially rely on our forehead muscles to maintain our brow position as we get older, and we don’t want risk dropping the brows, so on the forehead we’re trading lines against the amount of time it will last, as smaller doses last less time than stronger doses.
I have to carefully assess each individual person to achieve the results I want and to minimise the risk of side effects. All medical procedures have risks and benefits and a detailed consultation is essential. In Ireland you must see a medical doctor or dentist for a face to face consultation to assess you for suitability.
Don’t take unnecessary risks by seeing someone who is not medically trained, even if it seems like a bargain. Eithne

07/12/2025

If you’re considering an aesthetic medicine injectable treatment, how do we reduce the risk of bruising? There are things I can do and there are things you can do.
For me, having a detailed knowledge of anatomy is essential and I can use ultrasound too. I go slowly and gently and use an ice pack in a clean glove to help constrict the blood vessels to reduce the chance of bruising.
If I’m doing a dermal filler or collagen stimulating treatment, I’ll use a little blunt tool called a cannula so I can fan the product out under the skin using a gentle technique.
If I’m doing a botulinum toxin treatment, I’ll use the excellent little Vlow tool (not sponsored) with a tiny 34 gauge needle. These help a lot.
What you can do is to book in advance of any big events, be aware that bruising can happen even with all the measures above, try not to drink alcohol for a day either side of treatment, the same goes for smoking, let us know if you’re taking any blood thinning medications ( but never stop them! ), follow our aftercare, including no vigorous exercise/sauna/ steam room for 24 hours after treatment.
If you do get a small bruise, we can treat this with light or laser.
All treatments have risks and benefits so my advice is to always stay as safe as possible and see a registered, experienced medical professional to get the best outcomes possible and to help minimise side-effects. Eithne

Dr Eithne Brenner

20/12/2025

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Monday	9am - 7pm
Tuesday	9am - 7pm
Wednesday	9am - 7pm
Thursday	9am - 7pm
Friday	9am - 7pm
Saturday	9am - 6pm