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@dreithnebrenneraesthetic
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Combining Aesthetic Treatments: Our Clinic Approach
Hi, each clinic will have their own protocol for what type of treatments they’re happy to combine in a single session, and what they prefer to separate. Mine is shown at the end of the reel.
Lots of factors come into play.
We often want to separate treatments to see the benefit over time of individual treatments, deciding going forward if that’s worth the spend/downtime etc.
Also, I’m thinking, what depth am I doing this treatment at?
Is it an injectable at a superficial depth or is the target layer something deeper?
I’m not going to put two products at the same depth as I couldn’t tell which one gave the benefit and if there’s a side-effect, I need to know which treatment to ascribe it to.
I’ll often treat one area of the face with one treatment, and another area, say, the neck, with another.
I might put dermal filler in the temple, and an anti-wrinkle treatment in the lower face in the same session. Those are fine. Some combinations work well together. If I’ve somebody new, I say, don’t do too much in one session, because there’s a bit of discomfort involved with some of the treatments, and you want to be able to tolerate it, and not go in too fast.
We’re always mindful of many, many factors. We build a treatment plan, and there’s a temptation sometimes to cram everything in. But we’ve got to be really careful with your face and deciding the depth of treatment, the product compatibility, what’s our goal, what’s our long-term plan?
And just go nice and slow and steady.
I’ll show you some of our personal combinations here and other clinicians may have slightly different protocols.
Let me know your thoughts as well. Take care. Eithne
Planning Aesthetic Treatments for Better Results
Hi, Irish rain and ‘99s go great together!
What things are great in aesthetic medicine and what things are better left separate?
It depends on what area of the face/neck/body you’re treating, what depth you’re at, how much of an injury are you going to cause to the skin? What’s the recovery time, and what’s that person’s tolerance for discomfort and what their budget is?
We put together a plan, and most of the time, I prefer to separate treatments, because then I can see which one has actually given you a benefit. I can assess the results, but also, in the unlikely event of a complication, or where there is a side effect we might expect, where you’re sore or tender afterwards, or there is a bit of swelling, I would like to know which treatment is doing that.
If I do one treatment you may not need a particular second treatment (if the first meets your treatment goals), so there’s a budget element to it, as well as just being efficient with time.
The temptation for people coming to see me, especially if they’re travelling a long distance, is to be efficient and get as much done at the one time, but then you don’t know what’s the best bang for your buck going forward.
None of these treatments are urgent. You’ve got time to discuss it, and think about it, and plan your down time, if there is going to be some, and come up with a plan that really suits you.
It’s a marathon not a sprint, and it’s not getting as much done to your face in one session; it’s been really clever and selective about what you want to do, what you’re trying to achieve.
Stay as safe as possible if you’re thinking about an aesthetic medicine treatment, and see a medical practitioner.
I’ll list some good and not so good combos in the next video.
Take care. Eithne
Understanding Complications in Aesthetic Medicine
Hi. Complications can happen with aesthetic treatments, and we always want to minimise those. I had a complication here from an anti-wrinkle treatment from a colleague some time back, and it settled of its own accord, but let’s have a look at why it happened.
When we do anti-wrinkle treatment, we’re looking at complex facial muscles. And if we treat one muscle, we may impact nearby muscles, because the muscle fibres can overlap, or there’s individual anatomical variation, and it also depends on how concentrated the medicine is, how precise the placement is, and whether somebody goes exercising afterwards in the first four hours, or whether they rub those areas vigourously.
I had treatment for the muscle DAO, depressor anguli oris. It pulls down the corner of the mouth, and when we treat that, we get a nice, subtle lift of the corner.
There are also little muscles here, mentalis. That crinkles or crease the chin, and there’s little ones called DLI, depressor labii inferioris. The job of DLI is to pull down the lower lip, and then in some people, treatment will be done along the jawline, and neck bands, platysmal bands, that pull down.
When this muscle DLI was affected, instead of pulling down the lip, it lifted it up a little bit, and so I had a wonky or asymmetrical smile. I left mine alone, and it settled quickly, but if it happens, you can treat the corresponding muscle on the other side to stop that pulling down. And you get more balance.
Always stay safe. See an experienced medical practitioner, and your risk of complications will be minimised (but never zero, of course!)
Take care. Eithne
Understanding Needles vs Cannulas in Aesthetic Medicine
Hi. If I’m doing an aesthetic treatment, how do I decide between using a sharp needle or a blunt tool called a cannula?
It depends on lots of factors, such as the person’s individual anatomy. What are we trying to achieve?
What depth are we going?
How thick or how runny is the product?
And how can we keep it as safe and as comfortable as possible?
For some treatments like muscle treatments, we’ll use a very tiny, sharp needle, say, between the brows or around the crow’s feet lines. For a filler that’s a bit thicker, and I want precise placement on the bone, say, in the temple, or on the cheekbone, I’ll use a slightly bigger needle.
And then for work that’s underneath the skin where I’m covering a bigger area and fanning the product out, like a thicker biostimulator, like Radiesse, I’ll use a cannula which is blunt.
So, the choice of two really depends on all of those factors, and it’s not in either or; we use both of them and we use lots of different sizes.
We’re trying to keep it as safe as possible.
Both have the risk of a bit of discomfort, a chance of bruising, and then the complication we’re always trying to avoid with treatments is getting something into a blood vessel. Cannulas definitely have less risk of that happening, but it can still happen with a cannula.
The important thing is to see a really experienced practitioner who’s going to use the right tools for the right product and the right person and the right depth, and who’s going to help keep you as safe as possible.
Take care. Eithne
Please note vacation time for this summer. Online bookings are open. Thank you. 01 9602277
Understanding Acne Scar Treatment Options
Hi, what can you do for acne scarring on the face?
It depends on lots of variables such as the age of the person, what their type of scarring is (rolling/boxcar/ice-pick scars), what their skin type is, and whether they have active acne spots still.
As always, the key is prevention: treating acne early, avoiding squeezing spots and wearing a sunscreen to prevent further collagen breakdown.
If you’ve got early acne scars, things like retinoids (vitamin A skin products) can help reduce the redness and inflammation afterwards.
But if you’ve got really established acne scars, then we might have to look at some aesthetic treatments. One of the ones I liked a lot is SkinPen micro needling, because we can get down to depths of 2.5 millimetres into the dermis and help break up scars, and also boost collagen and trigger a repair process.
In somebody mature, acne scars will get worse, because we’re losing underlying bone structure, and the skin is losing elasticity and getting more crepy.
So, sometimes people who’ve had acne scars for decades will come in in midlife, saying that they look worse.
Sometimes we’ll replace volume with dermal filler, or boost collagen and improve skin structure with biostimulators like Juläine or dilute Radiesse, or we look at muscle treatments to reduce some of the creasing in the skin that’s contributing to the scarring, for example, on the forehead, or along the jawline, or corners of the mouth, and then sometimes we’ll use laser treatments to help.
I also like a technique called subcision, where I’ll go under the skin with a little tool called a cannula, to help break up some of the little fibrous bands that are tugging in and causing scarring.
Stay safe and always see a medical practitioner.
Take care. Eithne
The Science Behind Muscle Relaxation Treatments
Hi. Do anti-wrinkle treatments lift muscles?
The situation’s much more complex. Our facial muscles are like an orchestra, with all the instruments or muscles playing together at the same time, and creating a really nice system of complex facial expressions, and the ability to communicate with one another.
Some muscles will pull up, for example, frontalis lift the brows, some will pull down, like procerus and corrugator. Some will purse, like orbicularis oris. Some will pull down like DAO and platysma, and others will lift the mid face (zygomaticus major).
If we are looking at potential muscle treatments, we’re looking at what each muscle is contributing, what are the muscles around it doing? And if you impact one muscle, how are you going to impact the nearby muscles and the overall facial harmony or expression?
These are medical treatments, and the goal is not to eradicate movement or to freeze the face. If you want to achieve one result, for example, if you want to hear the violin a little more, you tune down the drums. If you want to lift the eyebrows you might treat or damp down the muscles that pull the brows down, allowing the lifting muscles to exert a stronger effect.
As a medical treatment, you want to see a medical practitioner who’s going to assess you face to face, and look at your individual anatomy, and muscle strength, and muscle movement, and decide if you’re suitable for treatment.
The goal is never to freeze or take away all expression. It’s to soften sometimes features that are perceived as negative, and to look at the complex way those muscles interact. So always stay safe and see a medical practitioner if you’re considering any aesthetic treatment.
Take care. Eithne
Angelika joins us as Dr Brenner's Aesthetic Assistant. She has an interest in advanced facial treatments and skincare. In conjunction with working alongside Dr Brenner Angelika will be providing Hydrafacials, SkinPen micro-needling, peels and facials. Join us in welcoming her to the clinic, we are delighted to have her...
Understanding the Natural Aging Process
Hi. More scribbling 🙄 to show you the changes that are going to happen our faces inevitably and predictably over time.
On the more youthful side, we have a nice contour, some nice padding or fat (we love fat on the face), and a nice brow height.
I’ve drawn the changes that are slowly going to happen over time to all of us. We accumulate sun damage, and the skin gets more lax and looser. We lose fat, especially in the forehead, the temples, the deep cheek, and in front of the ear, around the lateral parts of the face, and then the superficial fat tends to slide down.
We sometimes get eye bags; we get grooves and hollows. We get a deepening of the nose to mouth lines. We get some marionette lines, and some chin shadows and hollowing. We get thinning of the lips, and fine lines developing, and we get jowls forming. The muscles pull on the skin causing lines and wrinkles.
These are normal, predictable changes, and if you want to help address them, number one is protecting your skin from sun exposure, use good quality simple skin care ingredients, like SPF every single day, vitamin C, and vitamin A products.
We can boost collagen with microneedling and devices and we can do injectables that can help replace some lost volume and give back some support, and disguise some of the ageing changes, and we will sometimes try and get the brow to lift a little bit.
All of these treatments are medical, so ideally, see a medical practitioner, go through a full detailed consultation, look at the changes that are happening to you, and then, if you’re going to consider treatment, stay as safe as possible and only have treatment from an experienced medical practitioner.
These are all optional treatments and your medical health is the first priority.
Take care. Eithne
A Personal Approach to Subtle Facial Rejuvenation
Hi. Here are some medical treatments that I might consider for my wonky and asymmetrical, but very happy 60-year-old face. 🥴
As time passes, we start to get lines that form at rest, and also when we move, and the depressor muscles pull down the corner of the mouth, and then the neck pull down gets stronger. And we can end up looking a bit grumpy or a bit sad when we feel fine; what we call the resting bi€ch face, and here is mine.
I don’t do these treatments all the time, but occasionally, I will have treatments to just soften some of those expression lines.
You must see a medical doctor or dentist for a face-to-face assessment in Ireland to see if you’re suitable for it. My brows are asymmetrical as is my forehead, and so I have a different dose on either side to just soften those a little bit.
I have some Wi Fi or rainbow lines. They can be treated but just extremely cautiously and light, so that the brows don’t drop, because the brows are already dropping over time, especially at the sides as we get older. Little doses around the eyes and brows can soften crow’s feet lines and open up the eyes a bit and occasionally I might have treatment to reduce bunny lines.
Sometimes I’ll have treatment to reduce the fine lines around the mouth, soften the pull down of DAO (depressor anguli oris) at the corner of the mouth and maybe sometimes along the jawline and in the neck platysma muscles.
These are medical treatments, so you want to be as safe as possible. They are all optional. We’re not trying to freeze the face. We’re not trying to take away all expression. We’re just sometimes trying to damp down the muscles a bit that are causing a sad or angry appearance. And as always, stay safe and see a medical practitioner.
Take care. Eithne
Book your #skinpen for July or August and avail of the offer of Sásta microbiome serum for just €25. Irish made Sásta works by nourishing good bacteria and reinforcing the skin's barrier, it effectively reduces redness, diminishes inflammation, balances hydration levels, and minimizes signs of premature aging. Use 24 hours post SkinPen microneedling. #sásta #skinpen
Thank you Deirdre. We appreciate the generous feedback and it lets us know how we are doing...
Louise’s Obagi Blue Peel Radiance
Louise is having an Obagi blue peel radiance today. This has ingredients including salicylic acid and glycolic acid and lactic acid, as well as some calming ingredients.
We cleanse and degrease the skin, we protect the delicate areas with Vaseline, and then we’re going to apply up to four layers of the peel. This is really helpful to get nice radiant skin, to reduce congestion, to help turn over the cells faster, to help brighten the skin and give a glowy texture for several weeks.
You can see her skin is getting quite pink, and it will be feeling tingly, and she’s going to use the fan between layers to help cool down the skin. This is a normal response to the peel. Not all peals need to be aggressive. This one will achieve great results by being consistent with a course of lighter peels rather than aggressive ones.
She’s got some “pseudo-frosting” or white on the skin there, which is where the salicylic acid evaporates off the skin and that’s normal and clears when we remove the peel.
We’re going to clean the skin, put on lots of calming ingredients and SPF, and Louise can expect a really nice, glowy, hydrated skin over the coming weeks. The redness will clear in a few hours. There is minimal downtime and the skin will not shed or become dry. This is safe and predictable, and can a really lovely result for a glow.
All peels are personalised for each individual’s goals and skin condition.
This post isn’t sponsored. Eithne
Staying Natural: Avoiding Perception Drift
Hi, something we don’t talk enough about in aesthetic medicine is perception drift.
What is it? How does it happen, and how can we prevent it?
When you have an aesthetic treatment, you look a bit more refreshed, you gain a bit of confidence, and you’re happy with the treatment.
And you might go back for another one, and then another one, and another one. And before you know it, you lose sight of where you started, and you can end up looking either overfilled or unnatural.
It happens both to the patients, it happens sometimes to the injector. And that’s when it’s really important to take a step back in each individual consultation, have plenty of time, have a look back at old photos, you want to look like yourself, and not like somebody who’s progressively changing or morphing into somebody different.
I go to aesthetic conferences, and if I’m checking into a nearby hotel, I can generally tell, as well as knowing some of the faces, but I can also tell who’s likely to be going to the conferences, versus who are regular check in guests for the hotel. Because sometimes it happens among aesthetic injectors, as well. They’re tempted to try a bit more and a bit more.
Now, each person- patient or injector- can have individual preferences and look how they wish and have repeated treatments if they chose to, or want very full lips or cheeks, but you still want to be safe and careful and not look distorted. How do we avoid perception drift?
It’s really having careful consultations with your medical professional. It’s also checking with your friends and family. It’s looking back at old photos.
We don’t want to chase every line and wrinkle. We want to be really measured and careful, looking at skin quality and all the changes that are happening, and pick a subtle treatment plan. Take care. Eithne
Please call 01 9602277 to book or email your details to [email protected]. Appointments granted on a first come first served basis.. Thank you.
Should You Be a Model at an Aesthetic Training Event?
Hi, would I be a model at an aesthetic training event?
Today, I’m playing padel, and I put some ‘Sally Hanson Legs’ on my legs, because they’re blindingly white. And I thought I’d put some everywhere else 🙄🎃
Was that a good idea? No, but it’ll wash off this evening. If you’re a model at an aesthetic training event and you’re not happy with the treatment, you can’t wash it off.
I would just say exert caution, ask lots of questions beforehand. There’s a big difference between a beginner injector treating you as one of their first few patients, and a very experienced injector who’s, say, training in a procedure they’re already very familiar with, but they’re changing the product (one brand of dermal filler vs another).
So just ask lots of questions. Who’s doing the insurance? Is it the company who’s providing the device or the product? Is it the supervisor of the training, or is it the person who’s doing the treatment themselves? And what follow up care is there? Also, you have to be mindful about your images, giving permission to share them online.
You might trust the person who’s treating you, but, of course, there’s going to be somebody around the world claiming that ‘before and after’ is their work. It’s happened to all of us. I think just be very cautious, ask lots of questions. I’ve been a model at some events in my 19 years in aesthetic medicine, and some of them I’ve regretted, and some of them have been okay.
I think go in with an open mind. Don’t be tempted by a bargain, reduced price treatment, really ask lots of questions, and decide if it’s safe for you to go ahead. And make sure you’ve got plenty of time to give informed consent that you’re happy to proceed.
Take care. Eithne