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. [email protected]
(1)

01/09/2026

Hi, not all ageing necks are the same, and that’s really important when we’re talking about treatment options.
There are some things all of us can do to improve our necks, and that’s good quality skincare ( vitamin C and vitamin A skincare) , daily sun protection, and even something as simple as covering your neck from the sun can make a big difference over time.
But beyond that, people have different concerns. If the main issue is skin laxity, or crepy skin, then treatments like skin boosters, or SkinPen micro needling, or bio stimulator injectables ( like dilute Radiesse or Juläine ) can help improve skin quality.
If the issue is muscle activity, like the platysma pulling down, that’s where anti wrinkle medication can be useful if you’re medically suitable.
If you’ve got a pocket of fat under the chin, the approach is different again. Sometimes improving the definition along the jawline ( like HArmonyCa or Radiesse) can help disguise it.
Fat dissolving injections are another option, although they’re not something I routinely recommend, and I never recommend lemon bottle!!
And liposuction can be considered in selected cases, although it isn’t necessarily the answer for every neck.
If the main concern is pigmentation or sun damage, ( like poikiloderma of Civatte) then laser or light based treatments like BBL ( Sciton mjoule) can be appropriate. Although there are some common principles, like skin care and sun protection, being the big ones, there isn’t a one size fits all treatment for an ageing neck.
The important thing is to work out what the actual problem is and then decide, do you want to consider treatment? Take care, Eithne

30/08/2026

Hi from Buddy and me.
Oestrogen face cream, does it actually work?
I’ve been getting a few questions recently about oestrogen face creams and whether they’re something that we should be using for menopausal skin. We know that falling oestrogen around menopause and perimenopause have an effect on our skin.
We can see changes (losses) in collagen, elasticity, hydration and skin thickness.
And there are some really interesting studies looking at applying oestrogen or oestriol directly to the face skin. Some of these studies have shown improvements in things like epidermal thickness, and markers of collagen production.
But the important bit is that interesting science doesn’t automatically mean established treatment.
At the moment, there isn’t an oestrogen facial cream licensed specifically for treating menopausal skin ageing.
And I think that’s an important distinction. There are licensed oestrogen topical medicines.
For example, we use va**nal oestrogen really effectively for genitourinary syndrome of menopause.
But that doesn’t mean that the same medicine is licensed for face skin use. The va**na is a mucosal surface ( like the mouth), and not a typical skin surface, and we know that even low dose va**nal ostrogen can be absorbed systemically, although the levels are generally very low.
Facial skin is different. It has a much stronger barrier, and we don’t have the same quality of pharmacokinetic evidence.
So, although some women are anecdotally already using the product, I’m not suggesting that women should look for oestrogen face creams.
As healthcare professionals, we have to distinguish between what’s biologically plausible, what has been studied, and what’s actually licensed and recommended.
Because promising science is exciting, but promising isn’t the same as proven.
Take care. Eithne

29/08/2026

Hi, if you’re using some form of va**nal oestrogen, like a ring that’s in place for three months, or a pessary, or a tablet, or a cream, does it matter which one you use? They’re all effective at improving the symptoms of genitourinary syndrome of menopause. And that’s a cluster of symptoms that can happen during menopause, or periminopose, or other occasions when the oestrogen levels are low, and you can get local irritation, dryness, thinning of the skin around the v***a and va**na. You can get a higher risk of urinary tract infections( and sepsis!), and you can get discomfort with s*x or using s*x toys.
So the cluster of symptoms can be unpleasant, and all of these oestrogen products help. It depends on where your symptoms are. If they’re just va**nal, often the little tablet that you pop in with an applicator twice a week is effective. If your symptoms are more on the outside v***a, then you can use the creams and rub them in, and you can rub them in around the entrance to the va**na, called the introitus, around the hood, or top of the cl****is, and down towards the a**s, or back passage, in that area called the perineum. So it really depends on what you’re comfortable with. Also, simple moisturisers can help a lot, and then lubricants, if you’re going to have s*x or use s*x toys, can be really good as well.
So I would just say they’re all effective. They’re not going to give you what we call systemic HRT, so they’re not going to relieve symptoms like flushes and sweats and irritability and insomnia. They’re just designed to improve the local area. And if that’s something relevant for you, always speak to your medical provider and get lots of advice. Take care. Eithne

28/08/2026

Hi, if you’re breastfeeding and you’re thinking about an aesthetic treatment, what do you need to factor in?
There’s lots to untangle here. You’ve got to look at the procedure or treatment itself.
What are the risks for that procedure for both mum and for the breastfed baby?
You’ve also got to look at what might happen if you had a complication, which is unlikely, but can happen.
Say, you have a dermal filler treatment, and you think that’s relatively innocuous. But then you get a vascular compromise where the blood supply is under threat, or you get a skin infection, and you need to use medications to help counteract that; what impact would that have on the breastfeeding?
I personally am cautious.
I don’t like to do treatments that could have a potential impact on the continuation of breastfeeding.
There are studies showing that medicines like botulinum toxin can be detected in tiny amounts in breast milk. Now, that doesn’t seem to translate to any clinical significance for the baby, BUT there are limited studies of medicines and treatments, both in pregnancy and breastfeeding because of ethical considerations. And we know a lot of people want to look better after they’ve had their baby, but it’s a hugely beneficial process, both for mum and baby, to breastfeed ( if mum chooses to).
And personally, I don’t want to risk undermining that.
Treating someone with botulinum toxin for migraine while breastfeeding has a different risk benefit profile because it’s for medical reasons rather than for an anti-wrinkle purpose.
Have an individual consultation with your medical practitioner if you’re thinking about it.
Most of the manufacturers will advise against botulinum toxin during breastfeeding. Some say it’s the clinician’s decision
to assess the risks and benefits. There are studies that say the effects are likely to be fine, but just be careful and think through it all before you consider treatment.
Take care. Eithne

24/08/2026

Hi, as a 61 year old, and a doctor of almost 40 years, here’s my bag of things I always take with me when I’m travelling to see friends for the weekend.
This is not prescription advice. This is my regime, and I get this from my GP, and I have some over the counter items as well.
And apologies, it’s not going to be a 90 second reel. 🙄 I’ve got more high maintenance as I’ve got older, and my medical needs have increased a bit.
The first thing for me is my HRT regime. I have a Mirena coil ( progestogen). I have an oestrogen gel that I apply daily. I’ve got a testosterone gel; I use this sachet over 10 days, and then I have Vagifem va**nal oestrogen, which I use one of these twice a week. I will continue that long term.
I have a family history of early heart disease, so I take a small dose of a statin, and when my cholesterol is left to its own devices, it’s high, but with this, it’s very well controlled. I also watch other lifestyle things; I keep active, I don’t smoke, I drink very little, I eat a healthy diet, I prioritise my sleep, and my relationships with friends.
I take 2 small medications for high blood pressure or hypertension, and that helps reduce my risk of heart disease and strokes. I’m aware of my privilege in having access to healthcare of course.
I keep eye drops always with me for dry eyes.
We used to play kiss and chase when we were about 12, and those boys did not want to be caught, but we were bigger and stronger, so we caught them. Unfortunately, I picked up somewhere the little herpes coldsore virus and every so often I’ll get a little cold sort of my lip or nose. So I always keep a prescription aciclovir cream handy.
And then you will never see me without a lipstick. So that’s my regime. There’s a lot to it! I’ve got other skincare items. I’ll do a skincare video, but these are the core things that I always check when I’m leaving for the weekend.
What sort of products do you like best? Take care. Eithne

21/08/2026

Hi, let’s continue on the theme of just because you can do something doesn’t mean you should.
And let’s talk about p***s fillers. There have been some media reports of complications, and the British Association of Urological Surgeons have issued a consensus document about this.
They recommend that anyone considering any kind of procedure like this should have a detailed assessment with a ge***al surgeon, that they should have a psychological assessment if appropriate. They strongly recommend against products that don’t dissolve, so that would be permanent fillers, and they recommend against dissolvable products like hyuronic acid.
They also recommend against surgical procedures to widen or lengthen the p***s. There are risks with these kind of procedures, and there are clinics offering this who are not full time urological or ge***al surgeons.
The risks can include infection, pain, bruising, contour irregularities, and could include erectile dysfunction, and one complication that is to be feared is necrosis where the blood supply can be damaged, and there’s tissue death. These procedures do have risks, and there aren’t any great studies showing their effectiveness or their persistence or their safety. So I think if it’s something you’re considering at all, do a lot of research before you ever go ahead. I don’t offer this procedure. I have been asked, but it’s not within my area of expertise, so always be careful and see a specialised doctor, if you’re considering something like this.
Take care, Eithne

19/08/2026

Hi, if you’re considering an aesthetic medicine treatment, does it matter what your provider looks like?

It does to some degree!
What’s more important is their clinical expertise, and their skill and training, and knowledge of anatomy, and how they manage and recognise any complications that could occur.
I had a blepharoplasty ( eyelid surgery) about 10 years ago, and I researched the surgeon based on clinical expertise, and word of mouth recommendations from colleagues, and it didn’t matter to me what that surgeon’s face looked like. I was more interested in the skill.

It’s a bit more nuanced for some aesthetic treatments for people maybe considering a dermal filler treatment, it can matter if you’re considering a provider, and they have got very big filled lips, or they have something like very overfilled cheeks, then it does give an indication of their personal preferences.
A lot of medical providers who’ve had treatments over the years can look a bit exaggerated, or can layer one treatment on top of another, on top of another, and then there’s a tapestry or history in that face. So yes, it matters to some degree.
I was a GP in the UK for 16 years, and nobody ever came to me and said “Oh, you know, I’ve come to you ‘cause you’ve got nice blue eyes” 😂
It’s clinical expertise that the priority.

I would say the biggest thing is have a consultation with somebody, sit down face to face, have a look at their before and after pictures, and chat through your goals and their ability to provide competent treatment before you make any decisions at all.
What are your thoughts?
Take care. Eithne

18/08/2026

Hi, if you had areas of local fat loss, like hip dips, or you wanted fat enhancement of your breasts or buttocks, would you ever consider fat material that has been extracted from dead bodies or cadavers?

That’s what’s happening in the U.S. at the moment, with an injectable product that’s derived from donated fat.
The cadaver fat is processed. They try to extract as much of the DNA material as possible to reduce the risk of transmissible infections and to reduce the DNA below what’s called an immunogenicity threshold to try and stop that fat donation being rejected by the person having the treatment.
Yes, it seems very extreme. The product is a fat product, so it doesn’t have to go through the FDA process for new medicines or treatments, because it’s considered an existing product.
And it’s been used in body treatments. It’s not currently recommended for facial treatments, and to my knowledge, there’s no evidence of it being used in Europe or in Ireland.
It is being used in people who have low body fat where they don’t have enough fat to use their own body’s fat or where they don’t want to use this.
I think it would be very socially unacceptable to a lot of people, and also the risks of transmissible infections are not zero. We always want to be really safe with aesthetic medicine treatments, and we have to be really cautious and circumspect, wait for lots of evidence, wait for extended trials over a number of years before ever considering something.
It’s certainly not something I would ever consider doing or having.
So always stay safe, and ask lots of questions if you’re considering a medical treatment. Take care. Eithne

17/08/2026

Hi, why are some people disappointed with the result of their anti-wrinkle treatment?
If I think back to the birth of my first son over 31 years ago, my birthing plan included soft music and a TENS machine.
Did I get whet I wanted?
No, I got a husband who asked me to ‘keep it down a bit’ and ate all my snacks!
As in life, sometimes we don’t get what we want, and the same can apply to antiwrinkle treatments.

People have huge expectations and that’s fine; I do too, I want everyone to be happy with their results, but there are limits to what we can achieve, based on the individual’s anatomy, and the properties of the medicine.
If we look at the forehead muscles frontalis, they lift the brows, they give us that nice surprised expression but as time passes they’re creasing the skin, and causing lines at rest.
What you want ideally, is to have nice lifted brows with few lines and that’s just not possible ( especially as we get older) because the very muscles that are creating the lift are creating the lines.
The other areas that people tend to get disappointed with after a number of treatments are the crow’s feet lines, and that because there’s a lot going on here; there’s skin laxity, there’s damage from the sun and years of exposure to that, there’s repeated expressions, we get fat loss, the bone is changing, so it’s not just the muscle. Antiwrinkle treatment is primarily a muscle treatment. It’s not going to repair skin pigmentation or laxity, it’s not going to add back volume, it’s not going to give structural support like bone.
So always sit down with your medical practitioner for a face to face consultation and see what’s achievable for you and what kind of treatments and skincare might be useful for you.
(We had another son 3 years later, and we are good friends, which is lovely, but we’re no longer together ☺️) Take care, Eithne

14/08/2026

Hi, the European Commission has recently granted marketing authorisation for a new type of botulinum toxin treatment, called TrenibotulinumtoxinE.
This will be available in Ireland in 2027. It’s still a prescription only medicine, and like the current botulinum toxin A medicines available in Ireland, you need to see a medical practitioner for a face to face consultation for assessment.
What’s interesting about this new medicine is that has a very fast onset of action. It starts working within hours, and it has its full effect at 24 hours. It peaks at around seven days and by 14 to 21 days, it has mainly gone. Now, that’s really interesting. It might be suitable for somebody who’s nervous about a treatment lasting three or four months, but bearing in mind, this still has risks and benefits and needs individual medical assessment.
For somebody looking for a treatment result for a specific event that might be useful, it can be used in somebody who’s resistant to other forms of botulinum toxin. And the other thing I think it might have a use in, is in teaching, where medical practitioners could treat their patients at a training event on one day, bring them back the following day for an assessment of the full actions. I don’t think it’s going to replace the current medicines that are available on prescription in Ireland, but it will be another option to consider. And as always, stay safe as possible and see a medical practitioner and take care. Eithne

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