In this episode of Aesthetics Today, host Gabrielle Richens sits down with Dr Zunaid Alli, emergency physician turned leading aesthetic doctor, medical director of Edition Clinic (Wimbledon, London) and clinical product specialist for VIVACY / Rejuran, to unpack the real state of modern aesthetics.

This is a deep, honest and highly practical conversation for anyone interested in safe, evidence‑based aesthetic medicine – whether you’re a patient or a practitioner.

1. From Hospital Medicine to Aesthetics

• How Dr Alli went from ER, oncology and psychiatry in South Africa to running a leading London aesthetics clinic.
• Why aesthetics started as a reluctant “side hustle” and turned into a full medical vocation.
• The role of his background in clinical psychology/psychiatry in how he approaches consultations and patient care.

2. Patient Psychology, BDD & Red Flags

• The crucial difference between Body Dysmorphic Disorder (BDD) and dysmorphic traits that most of us have.
• How to gently spot red flags, set boundaries and safely refuse treatment when expectations can’t be met.
• Why cooling-off periods and strong referral networks to psychologists are essential in ethical practice.

3. Threads, “Cowboys” & Regulation

• What PDO threads actually are, how they work and why most people are not good candidates.
• The importance of patient selection and realistic lift limits (around 1.5 cm).
• A clear explanation of the UK regulatory landscape:
  • Why non‑medics can still inject in much of the UK.
  • Dangers of counterfeit toxin, fillers and even Rejuran sold online.
  • Why cheap injectables should be a major red flag for patients.

4. Natural vs “Done”: Treatment Philosophy

• Why “natural” is easy and “fake” is actually hard when you understand anatomy.
• The difference between replacing lost volume versus creating structures that were never there (e.g. over‑projected “cat cheeks”).
• Why Dr Alli hates dissolving filler for non‑emergencies and why filler is not “try before you buy”.
• What separates a competent injector from a truly elite one: treatment planning, aftercare, and being effectively on-call 24/7 for patients.

5. Fillers, Filler Fear & The Shift to Regenerative Aesthetics

• Why we were all told for years that HA filler “just disappears” – and what MRIs and newer research actually show.
• The emergence of “filler fear” and the wave of patients dissolving long‑standing filler.
• How filler now sits as one tool in a broader, more regenerative plan rather than the main event.

6. Polynucleotides & Rejuran Explained

• What polynucleotides are, how they evolved from early “salmon DNA” mesotherapy to true PN.
• Why Rejuran is structurally different: higher concentration, longer DNA chains and a scaffolding “lattice” that gives longer tissue contact and faster, stronger results.
• Why under‑eye treatment has become one of the biggest indications:
  • Fine lines and crepiness
  • Dark circles (including on darker skin tones)
  • Patients who want results without peri‑ocular Botox.
• Real clinic data: 7 out of 10 polynucleotide treatments at Edition Clinic have been for the under-eye area.

7. Regenerative Treatments 101

A clear breakdown of the main categories:

Skin boosters

• Primarily hyaluronic acid-based, but not the same as filler.
• Designed for hydration and skin quality, not structure or deep volume.

Biostimulators

• Products like Sculptra, Radiesse, Harmonica, Novuma, Threads (PDO/PLLA), etc.
• Work by triggering controlled inflammation to stimulate collagen and elastin.

Polynucleotides (PN)

• True regenerative healing and repair agents.
• Improve cellular function, texture, fine lines, elasticity and under‑eye quality.

Exosomes

• Tiny extracellular messengers that enhance cell-to-cell communication and repair.
• How Dr Alli safely uses them: topically with microneedling/RF/lasers, not injected.

Energy‑based devices

• CO₂ laser, RF microneedling (e.g. Morpheus), HIFU, IPL, Nd:YAG, hair removal lasers, etc.
• Where they fit into long‑term collagen and skin health, and why they’re ideal for patients who don’t want injectables.

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