Dr Eithne Brenner

Dr Eithne Brenner Expert in Aesthetic Medicine, Dublin. Medical doctor for 36 years. Helping you look and feel your best. Subtle, natural results. dr.brenner@dreithnebrenner.ie
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19/11/2025

We always connect Botulinum toxin with wrinkle reduction but this only accounts for about one third of all the botulinum toxin medicine produced. The other 2/3 is used for muscle disorders, for example to reduce muscle spasm in cerebral palsy, to reduce over activity of the bladder muscles, to reduce headaches associated with chronic migraine and to treat many pain disorders.
Today I treated a lady in the clinic for hyperhidrosis which is excessive sweating under the arms. There are many treatment options available and one of these is to use botulinum toxin in tiny little injections spread out under the armpits. We use a starch iodine test to outline the sweating area as this can be a little different to the hair-bearing skin and we want to make the treatment as effective as possible and not miss any little areas. We use numbing cream too and the discomfort is very minimal.
The medicine reduces the connection between the nerve fibres and the sweat glands, resulting in sweat reduction of up to 90% or more. This can last anywhere between four months and about nine months and varies between individuals. If you reduce the sweating under the arms, you don’t get compensatory or additional sweating in any other parts of the body. In Ireland botulinum toxin is a prescription only medicine and you must see a medical doctor or a dentist for a face-to-face consultation to assess you for suitability. Stay as safe as possible and only see experienced registered medical practitioners. Ask to see the medicine and expiry date too as your health and safety are paramount. Eithne

18/11/2025

Continuing on the theme of safety ( as always!), if you’re having an injectable treatment, the medical practitioner doing your treatment should always show you the product, open it in front of you, and show you the expiry date and the details.
I’ve been a doctor for 36 years. I was a GP for 25 years and with every injection or vaccine I always showed (and documented) the details and expiry date of the product. This is part of the inherent trust and integrity and best practice that is expected of doctors and medical staff. We only source our products and medicines direct from the manufacturers, or through a single wholesale pharmacy that we’ve built up a relationship with over many many years. That ensures we are acting as safely as possible. We know there’s a lot of counterfeit product out there. We will never buy products from random websites or from unsolicited emails. Legitimate packaging and products look very familiar and they will detail when and where the product was made, what the expiry date is how that product should be used and many will have QR codes, holograms or laser printing for additional security.
Never feel embarrassed or unsure about asking to see the product if it’s going into your face or body; your health and safety or paramount. My advice is to only see a registered medical practitioner who’s licensed to practice in Ireland, who’s going to treat your face and body with the respect that they deserve and who will act in your best interests, suggest potential treatments, but never make you feel under pressure to undergo a treatment or procedure. Eithne

17/11/2025

The Irish Medical Council issued a statement this week on the prescribing and administration of Botulinum Toxin.

Botulinum toxin is a prescription only medicine in Ireland, and may only be prescribed by a registered medical practitioner or dentist.
The statement reminds doctors of their professional and legal responsibilities when prescribing and administering botulinum toxin products.
“Misuse or administration by unqualified people places patients at serious risk of harm, including infection, paralysis or life-threatening complications. “
Unfortunately we know that there is widespread illegal and unsafe practice in Ireland with non-medically trained people administering this prescription only medicine.
Over 40 people became ill with botulism in the UK over the summer from a non-medically trained person administering illegal and counterfeit toxin.
The role of the HPRA (Health Products Regulatory Authority) is to ensure that products are of suitable safety, quality and efficacy, and used appropriately.
The statement continues “The sale, supply, or administration of botulinum toxin by unqualified or unregistered individuals is illegal, unsafe and unacceptable. Patient safety must always take precedence.”
My advice is to stay as safe as you can and if you’re considering a treatment, see an experienced and qualified medical doctor or dentist for a consultation. It’s not worth taking risks with your face and your health. Eithne

15/11/2025

We had a great question from yesterday’s video. Can you put botulinum toxin or anti-wrinkle medication under the eye area?
The answer is yes, sometimes and very cautiously!!
The eye muscle orbicularis oculi is made up of two parts, the outer part is called the pars orbicularis, and the inner part is called the pars palpebralis.
Some people have a strong pars palpebralis resulting in what’s called a ‘Jelly Roll’, or a bulge under the eye.
If this is something that bothers you, it can be treated with a tiny dose of botulinum toxin ( anti wrinkle ) medication, which reduces the bulge and opens up the eye a little bit.
We do a snap test to see if the skin is elastic and bounces back quickly and if it’s slow (like my 60 year old skin), you’re not suitable for this treatment.
People with eye bags or hollow under eyes or who are prone to eyelid puffiness are not suitable either.
All medical procedures have risks and benefits and the risks with this are that the eyelid can drop too much and you get an ectropion, and/or dry eyes which can take 3-4 months to resolve. Ectropion can happen in elderly people as a result of ageing and muscle weakening, and we certainly don’t want to cause it with botulinum toxin. So yes, I do it, but only in very selective situations.
Botulinum toxin is a prescription only medicine in Ireland, and you must see a medical doctor or dentist for a face-to-face consultation to assess you for suitability.

14/11/2025

What are the two drop (ptosis) side-effects that we want to avoid with botulinum toxin, aka anti wrinkle medication?
Our forehead muscles frontalis are the only brow lifters or elevators and over time our brows sit lower and we develop lines on the forehead.
If you’re having treatment in the forehead, we have to keep the dose light to avoid dropping your brows or making them feel heavy. This can make it harder to apply eyeshadow or mascara and can make you look cross or tired.
We have to go especially light in people new to treatment so we can assess the dose needed, in people with a short forehead or in those with hooded lids, heavy flat brows or in those who at rest have elevated brows and lots of forehead lines.
We have to be very careful in treating the frown muscles and crows feet lines to avoid affecting the eyelid lifting muscle levator palpebrae superioris, as if we affect this, the eyelid drops. These issues will wear off but they are avoidable and preventable with careful individual assessment, and correct technique.
In some situations, eye drops or additional toxin in nearby muscles can help improve the drop, while the medicine wears off and the drop resolves.
In Ireland botulinum toxin is a prescription only medicine, and you must see a registered medical doctor or dentist for face to face assessment for suitability.
Ask to see the product that is being used, ask lots of questions and stay as safe as you can. All medical procedures have risks and benefits, so discuss these in detail. These treatments can be very effective in reducing wrinkles and lines and softening some of the signs of ageing, but it’s a personal choice whether you consider it or not.
Not everyone is having these treatments, although it may seem like that from social media. Never see someone who is flying in from another country for the weekend, they won’t be insured and are acting illegally and won’t be storing or using the medicine appropriately.
Never take unnecessary risks with your face or your health.

12/11/2025

Let’s chat through hyaluronidase or hyalase.
This is a prescription only injectable medication that can help dissolve hyaluronic acid dermal fillers.
There are two situations where it might be used. The first is in the very unlikely event during dermal filler treatment a tiny amount of filler gets into a blood vessel and needs to be dissolved straight away. This is called a vascular occlusion and there’s usually a window of a few days to dissolve the product with full recovery.
The second situation is if somebody has a dermal filler treatment that might be overdone, for example overfilled lips, or too much filler, for example the ‘pillowface’ look we see in some celebrities.
Hyaluronidase is not a simple ‘eraser’ however. Some fillers are much harder to dissolve than others, it make take a few sessions to dissolve the filler, you might not know the product type or where and at what depth it was placed, and how clean the original procedure was.
If a filler isn’t hyaluronic acid it won’t be dissolvable with hyalase.
The tissue may be overstretched and not bounce back after dissolving.
The filler draws in water and you lose this plus a little of your own hyaluronic acid temporarily, so this needs time to settle.
Time may have passed since your treatment and you’ve aged normally in that time, plus there’s the reason that you had treatment for in the first place, for example hollow under eye areas, that return when the filler is gone.
I’ve used dermal fillers for almost 20 years in my clinic and have them injected in my own face by a colleague, in small amounts, keeping the results natural and subtle. They can be really useful to restore lost facial volume, help balance facial asymmetry and subtly soften some of the sagging and loss of skin elasticity over time. We also have non-filler options too.
My advice is always to to see a highly skilled and experienced medical professional who will take a cautious approach, use them very carefully and subtly and be aware of all the risks and benefits and treat you safely and professionally.

11/11/2025

If you have regular antiwrinkle or botulinum toxin treatment and you let it wear off is anything bad going to happen?
No, it’s fine. You can stop treatment at any point and your results will wear off and your muscles will recover their function and bring you back to the baseline where you started.
I’m 60 and I’ve had a regular treatment for 20 years.
Over the summer I decided to let my treatment wear off completely and see what my baseline muscle activity was. I was quite surprised 🙄 I had a very obvious resting B face because there’s background activity or ‘tension’ in the face muscles even when our face is resting. As we get older there’s more activity in the depressor or pulling down muscles especially in the lower face and neck and you can see how active my neck muscles were. Think Deirdre Barlow from Coronation Street ( if you’re my generation 🤦‍♀️). I had a subtle treatment; my goal is to soften expression lines and not get rid of them completely. I want to look fresher but not frozen.
*There is different lighting in the videos and I have makeup on this evening, but you can see the softening of lines.
In Ireland you must see a medical doctor or a dentist for a face-to-face consultation to assess you for suitability. Always stay as safe as possible by seeing registered and experienced medical professionals.

10/11/2025

Why is our first consultation with you so long?
We book 90 minutes for the first consultation so that we can have a really in-depth discussion with you.
We need to know your medical history, medications, HRT, supplements, allergies, lifestyle, skincare routine, goals and your wishes and your timescale and budget. All information is kept strictly confidential.
I’ve been a doctor for 36 years and I’ve worked in Aesthetic Medicine for 18 years and over that time, my first consultation has got longer and longer.
I’m seeing people with very complex changes to their faces over time.
Many people have had treatments elsewhere and I need to know who has done what and why, have they been happy with the results, was the treatment suitable for them? Were their expectations realistic?
Were they overpromised results?
I’m also seeing older people which is great, as it’s never too later to improve skin texture and look at reducing sun damage and reducing some of the changes that inevitably happen with skin aging, sagging, pigmentation and loss of volume.
The overriding issue for me is safety and assessing medical suitability and seeing if we are a match for one another, and if so, we can make a plan for subtle, natural, effective treatments over a period of time.
We’re not a buy two areas, get one free venue.
We don’t do big unnatural lips.
We don’t do overfilled faces.
We don’t do bargains.
We never cut corners on safety or product quality.
We never rush treatments.

What we do is careful, detailed, honest, gentle, professional and personalised advice. We love to build relationships over time.
We build in time for treatment on the day, but you’re also free to go home and think it over.
We respect your trust in us and your time and we want the best outcome for you.
We have these treatments ourselves and we want to subtly enhance your skin and your appearance and boost your confidence, all the while being as safe and careful as possible. Eithne

08/11/2025

Some more Saturday scribbling before I head home for dinner with my twin 🥳
Let’s chat about skinboosters.
This is a recent term, although we’ve had these injectable products for a decade or more. The term loosely describes hyaluronic acid injections in the skin, to boost collagen, hydrate the skin, improve skin texture and help prevent dryness or crepiness. They don’t add bulk or volume to the skin. They don’t lift. They last between 6-9-12 months on average.
We differentiate these from dermal fillers that primarily add volume, although they are made from the same ingredient hyaluronic acid.
How they work is dependent on the formulation, the degree of cross-linking and the concentration of the ingredients- these vary between products and we choose the one best suited for each individual’s concerns.
To be effective we have to place the product just under the skin and we can use a small blunt tool called a cannula, fanning the product out, or we can do multiple tiny injections with a needle and mould the product.
When we use the skinbooster Profhilo, we inject this in five spots on each side of the face and the product spreads out itself under the skin.
Results are noticeable within a few days and can last up to 12 months. Because the product is runnier and less cross linked than regular hyaluronic acid fillers, it doesn’t last as long, but it can be repeated as desired.
Having a skin booster is a medical treatment and you should have a detailed, personalised consultation with a highly experienced medical professional to stay as safe as possible.
Other effective injectable products that can come under the ‘skin booster’ term ( and that I like and use in the clinic) include polynucleotides, Sunekos, Juläine, HArmonyCa, and others.

07/11/2025

Things I would tell you as a medical doctor for 36 years and an aesthetic doctor for 18 years, if I wasn’t worried about hurting your feelings….
Wear the sunscreen EVERY single day: it’s your strongest protection against sun damage and skin cancer, lines, wrinkles, sagging skin and pigmentation.
Aesthetic medicine treatments are not for everyone, don’t do it if you don’t want to, but if you do, recognise that it needs time, consistency and financial input.
These treatments need maintenance. It’s like going to the dentist for a filling, you continue to brush your teeth at home every day.
If you want to get the best results, you’ll also need to look at your lifestyle, sleep, diet, exercise, stress, alcohol and smoking habits.

Don’t look for bargains when it comes to your face, see a very experienced medical professional to stay as safe as possible.
Have a detailed consultation for assessment and discussion of your expectations. Don’t expect results like filtered and photoshopped celebrity images, these aren’t realistic.
These are medical treatments that carry risks, they should not be casual or impulsive decisions, take your time, none of these are urgent in any way and your medical health is always the priority.
(My aesthetic and medical journey included internal and external work; I had lots of input and support from friends and my GP, HRT, an antidepressant, ending a very stressful relationship, lots of exercise, sleep, good food, and reading and reflection, and a fair few tears along the route. The external work includes very consistent SPF, vitamin C and vitamin A skincare, and a combination of SkinPen microneedling, subtle filler and collagen stimulator injectable approx each 2 years, blepharoplasty surgery under local anaesthetic a decade ago, some laser and some botulinum toxin. It sounds like a lot and it is, but it’s slow and steady and works for me. Your wishes goals and might be completely different to mine.)

05/11/2025

What treatment options are effective to lift the eyebrows?
As time passes the eyebrows get heavier and flatter. The reasons behind us are complex and include loss of fat sun damage to the skin and changes in muscle and bone structure.
Some effective non-surgical treatments include botulinum toxin to treat the depressor or frowning muscles, which gives a subtle brow lift for 3-4 months.
Dermal filler injection can work too, and can last 2-3 years or more.
Non-surgical devices like Ultherapy may give a very mild lift.
Some doctors use threads: I’m not a fan at all, I’ve never seen independent results showing results that last and I don’t do them.
Surgical options include an endoscopic brow lift where a plastic surgeon will make incisions in the hairline, and reposition or lift the tissues and stitch in place.
Botulinum toxin is a prescription only medication and in Ireland you must see a medical doctor or dentist for a face to face assessment for suitability.

04/11/2025

How can you end up looking like Red from Angry Birds with botulinum toxin (anti-wrinkle) treatment?

Face muscles are complex ( to allow us to make wonderfully varied and detailed facial expressions) and if you treat one muscle you are going to affect nearby muscles.
Incorrectly placed Botulinum toxin too close to the brows in the lower forehead can make the inner (medial) part of the brows feel and look very heavy, especially when combined with under treatment of the outer (lateral) part of the brows, where the brows pull up at the sides : not a good look!
It will wear off or you can help balance the brows with very specific doses of toxin to help as it wears off.
Seeing a highly experienced doctor or dentist will help avoid this look!
Botulinum toxin is a prescription only medicine, and in Ireland you must see a doctor or dentist for a face-to-face consultation to assess you for suitability.
All medical procedures carry risks so you need an individual detailed consultation to be as safe as possible, to get you the best results and to minimise side effects, especially heavy brows or heavy eyelids.

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