Dr Nyla Raja meets me cross-legged in the largest treatment room of her eponymous medispa. The lighting is cold and harsh — not quite as it would be in a hospital or Harley Street clinic, but enough to say this place means business.
Raja is the cosmetics doctor to the nought point nought one per cent: a dermatological Wonder Woman and Mayfair’s surgical siren. She opened her first clinic up north, among the bucolic pastures of Alderley Edge — the heart of Cheshire’s golden triangle — where her clients included Abbey Clancy, Coronation Street’s Helen Flanagan and practically the entire cast of The Real Housewives of Cheshire.
Some years later, she set up shop in London. “We’re the biggest doctor-owned clinic chain in the UK,” Raja beams.
Since winning the Top Cosmetic Clinic Award in 2019, she’s been busier than ever. “Most of my clients are 39, 49, 59,” she reveals, and thus contemplating a new dawn at the turn of a decade.
Their profile? “Company owners, CEOs, people who’ve got time for themselves,” she says. “It’s people who really need help,” she continues, “who need advice but are educated enough to understand that a healthcare professional, a doctor, should be leading their transition. I’m not interested in people who are looking for quick fixes.”
The Dr Nyla Medispa is as selective as the private members’ clubs that pepper the neighbourhood. It sits in a converted townhouse at 32 Dover Street, the Mayfair artery that’s become like a miniature longevity-industrial complex.
Clinics like hers and the London outpost of the Lanserhof (at number 18) sit side by side with five-star hotels, high fashion stores and Maison Estelle.
I feel sorry for these girls. They see Adele and Kim Kardashian losing weight and think they can do the same
Turbocharged weight loss
Raja mentions categorically that she won’t accept children. It seems an obvious statement coming from a cosmetics doctor — treatments like Botox and dermal filler cannot be legally administered in the UK to those under 18.
But when you consider how easy it is to cut corners, she says, it’s worth emphasising. What does she mean?
Pretty much anyone can order Botox online, with little to no checks or balances in place. It’s also the case with Ozempic, Raja’s current bête noire.
That and other “miracle” weight-loss drugs, which mimic the feeling of satiety and reduce a person’s appetite, are typically welcomed by doctors and healthcare practitioners — but not this one.
It is true the UK has an obesity problem: government figures show that more than half the adult population is overweight. Weight-loss drugs have been touted as a possible solution by the Health Secretary, Wes Streeting, who also believes it will solve the issue of economic inactivity.
Obesity is estimated to cost the UK £15.1 billion annually in lost productivity. Last October, the Government announced it would be investing £300 million in trials for weight-loss jabs under a new partnership with the US pharmaceutical company, Eli Lilly.
But Raja, who has a diploma in dermatology, is worried about the effect of weight-loss drugs on the skin, which she argues is akin to trauma.
The likes of Ozempic, Mounjaro and Wegovy induce “such dramatic weight loss” that the skin cannot keep up with the changes affecting the patient’s body. “Normally, weight loss is a slow and sustained process,” Raja says.
But turbocharged by pharmaceuticals, it causes “such rapid fat depletion” that “the actual proteins in the skin — like collagen and elastin — don’t have time to develop and adapt”. People are left with what she calls a “deflated appearance”, and which the internet has termed “Ozempic face”. “It’s why everyone in LA looks sad now,” a friend in California tells me.
Raja says her clinic has been inundated with a new kind of client: the Ozempic patient. “I feel sorry for these girls,” she tells me (users are more likely to be female). “They see Adele and Kim Kardashian losing weight and think they can do the same” — except they rarely have the same resources (“the personal trainer and the private chef preparing protein-rich meals,” Raja clarifies).
We need “a slower, more gradual approach to weight loss”, she argues: one that gives the skin “time to adjust”. “People who go on Ozempic need strength training to maintain or even increase muscle mass,” she says.
This provides “structural support” and “helps reduce the appearance of loose skin”. Also vital, Raja adds, are “hydration and nutrition, adequate protein intake and collagen supplements”.
‘Off-label’ drug fears
All this, of course, takes time and money. Raja acknowledges this is a social issue as well as a medical one. Her clients may have enough money in the bank to correct their mistakes if things go awry (she offers cutting-edge skin tightening treatments including radio frequency, ultrasound and needling, administered by a range of machines which she’s developed with an engineering firm — the name of which she refuses to give out). But others will struggle.
The trend for weight-loss jabs has exposed a rift between the haves and the have nots: with the cost of Ozempic standing at £150 per 0.25mg, Raja claims many people (particularly young girls) are turning to off-label drugs and dangerous concoctions they see on social media.
She speaks of one patient who came to her after making an “at-home” version of Ozempic using a powder she bought off a TikTok influencer. Last summer, the World Health Organisation issued a warning over a spate of “fake Ozempic” drugs in circulation.
“It’s important that doctors like me are kind of like role models,” Raja says, in the hope that her warning will be heard far and wide. Her clinic may be for the one per cent, but her message is for everyone.
