Sunekos is a patented, CE-marked injectable skin-regeneration treatment that combines non-cross-linked hyaluronic acid with HY6AA, a balanced complex of six amino acids: glycine, L-proline, L-leucine, L-valine, L-lysine HCl and L-alanine. Medisha uses Sunekos Performa, the latest-generation formula, and Sunekos 1200. These six are the precise raw materials the collagen-making cells in your skin need to build collagen and elastin. As we age fibroblasts slow down partly because those raw materials become scarce; Sunekos supplies them directly at the point of need. The result is renewed production of collagen types I, III and IV, elastin and fibronectin. The structural proteins of young skin. Unlike dermal filler it adds no volume, and unlike a standard HA skin booster it does far more than hydrate. Results build over a course of four sessions spaced 1–2 weeks apart: early change in texture and glow from 7–10 days, peak firmness and elasticity 8–12 weeks after the last session, lasting 6–9 months with twice-yearly maintenance. At Medisha Clinic it is delivered using The Medisha Method by Dr Nish Shah MD, the Official UK Trainer for Sunekos.

At Medisha Clinic in Mayfair a single Sunekos session is £350 and the recommended course of four is £1,100 — a £300 saving against individual sessions. Maintenance sessions after a completed course are £350. Consultation with Dr Nish is £50, redeemable in full against treatment, so if you go ahead the consultation costs nothing. A course review is included. The clinic is at 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street station.

Four. That is the clinically validated protocol and the one Dr Nish teaches: four sessions spaced 1–2 weeks apart, so each session builds on fibroblast activity stimulated by the last. A single session produces a short-lived improvement in hydration and glow but not the structural regeneration that makes Sunekos worth having. Two or three sessions produce a partial result. After the course of four, a single maintenance session every 6–12 months sustains the result because the collagen scaffold you have built provides a foundation. For the under-eye area or hands, some patients need only three sessions — Dr Nish reviews the response at each visit and will not ask you to have a session you do not need.

Expect the first visible change — better hydration, a healthier glow, slightly smoother texture — around 3–4 weeks after your first session, as fibroblast activity rises. The improvement then builds with each session. Peak results arrive 8–12 weeks after your fourth session, once the new collagen and elastin have matured: this is when firmness, elasticity and fine-line softening are at their best and when your review photographs are taken because the improvement is structural rather than a hydration effect, it lasts longer than a standard skin booster. Typically 6–9 months, varying with age, sun exposure, smoking and skincare, and it is cumulative: a maintenance session every six months keeps you at or near peak and builds on it.

Both are injectable skin-quality treatments. The difference is the mechanism. Profhilo is ultra-pure NAHYCO hyaluronic acid, 64mg per treatment, injected at five points per side and left to spread through the dermis, where it hydrates intensely and triggers bio-remodelling as the tissue responds. It is superb for sagging and dehydration and needs only two sessions four weeks apart, lasting 6–9 months. Sunekos combines HA with six amino acids that fibroblasts use directly to synthesise collagen and elastin. It is injected as many small into the skin deposits, needs four sessions, and produces more targeted regeneration of texture and fine lines, and it is safe under the eyes, where Profhilo is not used. In practice: Profhilo for lax, dehydrated skin; Sunekos for crepey, fine-lined, thin skin and the under-eye area. Many patients benefit from both in sequence. Dr Nish is the Official UK Trainer for Sunekos and performs both, so his recommendation is based on your skin rather than on what he offers.

Sunekos Performa is the latest-generation Sunekos formula and the one Medisha uses for most areas. All Sunekos products pair non-cross-linked hyaluronic acid with HY6AA — the patented six-amino-acid complex. But Performa carries a refined amino-acid profile that the manufacturer’s data show stimulates fibroblasts more effectively than the original Sunekos 200 it supersedes. It is used on the face, the delicate under-eye area, neck, décolletage and hands. Sunekos 1200 is a denser formulation with more hyaluronic acid, used on the face where deeper, more structural stimulation is needed. Often combined with Performa in the first session of a facial course. Using 1200 under the eyes is a common error that causes prolonged small bumps. Using Performa alone on a lax cheek under-treats. Choosing the right formulation for each area is step two of The Medisha Method and one of the main things Dr Nish teaches other practitioners as Official UK Trainer.

Yes — Sunekos Performa is one of the safest and most effective injectables for the under-eye area, and it is one of the main reasons patients come to Medisha for it. The under-eye skin is the thinnest on the face and sits over a dense network of vessels and fluid-drainage channels, which makes dermal filler in this area high-risk and often unsuitable for crepey, translucent skin. Performa adds no volume, so it cannot cause puffiness or the bluish blue tint under the skin. It is placed into the skin, above the vascular danger zone, and it thickens and firms the skin itself, which is what reduces the crepey texture and translucent dark circles. For genuine hollowing (a structural tear trough) filler is still the right tool, and for vascular dark circles polynucleotides may be added. Dr Nish assesses which you have at consultation.

Very little. Immediately after treatment you will have small raised small bumps at each injection point. This is normal and means the product is in the right layer. They flatten within 6–24 hours. Mild redness lasts 24–48 hours and occasional pinpoint bruising settles within a week. Most patients go straight back to work. For 24–48 hours avoid make-up on the area (12 hours), touching or massaging the injection points, strenuous exercise, saunas, steam rooms, sunbeds, alcohol and active skincare such as retinoids or acids. Apply SPF daily. There is no restriction on flying, driving or normal social activities.

Yes, and the best skin-quality results at Medisha usually come from a planned combination. Sunekos with Profhilo in sequence pairs amino-acid regeneration with deep hydration — Dr Nish’s most-requested programme. Sunekos Performa with polynucleotides under the eyes addresses both thin skin and vascular dark circles. Sunekos after a PDO Thread Lift improves the quality of the skin that has been repositioned, so the lift looks better and lasts longer. Sunekos alongside dermal filler treats texture and volume at the same time. Different injectables are usually spaced 2–4 weeks apart rather than given in the same session so each can be assessed on its own; Dr Nish will design the sequence at consultation.

No. Sunekos improves the quality of the skin — its firmness, thickness, elasticity and texture — without adding volume or changing facial shape. That is precisely why it is safe under the eyes and why nobody can tell you have had it: the face looks rested and the skin looks healthier, but the proportions are unchanged. If your concern is lost volume — flattened cheeks, hollow temples, a recessed chin — dermal filler is the right treatment and Sunekos will not replace it. Many patients have both, because ageing skin and lost volume are separate problems. Dr Nish will tell you at consultation which of the two, or which combination, addresses what you are actually seeing.

Sunekos has an excellent safety record: it is CE-marked, naturally accepted by the body, and contains nothing that is not already present in human skin. Expected, temporary effects are small bumps for up to 24 hours, mild redness for 24–48 hours, and occasional pinpoint bruising for up to a week. Uncommon effects include prolonged small bumps (usually from the wrong formulation or depth — avoided by correct technique), swelling lasting a few days, and, rarely, infection at an injection point (prevented by sterile technique). Allergic reaction is very rare because the ingredients are hyaluronic acid and essential amino acids because Sunekos is placed into the skin and adds no volume, the vascular complications associated with dermal filler do not apply in the same way. All risks are discussed at consultation and every session is performed by a medically trained doctor.

One reason above all: Dr Nish Shah MD is the Official UK Trainer for Sunekos. The practitioner the manufacturer certifies to teach other UK doctors and nurses how to deliver it. The treatment that won the Innovation and Pioneering Award at the Diamond Awards 2019. Most clinics offering Sunekos learned it on a short course. At Medisha you are treated by the person who runs the course. Every session is performed by Dr Nish personally using The Medisha Method, with the formulation (Performa or 1200) chosen for each area and the course reviewed session by session. He is also a medically trained doctor, Senior International Clinical Trainer at Derma Medical. Brand Ambassador and Key Opinion Leader for dermal fillers, and performs Profhilo and polynucleotides too, so his recommendation is based on your skin, not his stock. Course of four £1,100; £50 consultation redeemable. 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street. Also Marylebone.