This review evaluates the Dental-centric American Academy of Facial Esthetics (AAFE or facialesthetics.org) in comparison with industry-standard Botox and dermal filler training for physicians and nurses. AAFE offers ADA-recognized dental CME and membership-tiered programs, but lacks transparency in instructor credentials, and often relies on large class sizes and high-cost, multi-level course structures.
Page last updated February 15, 2026.
Key Facts at a Glance for AAFE Botox Training
- Organizational Structure: While their ambitious name indicates some status as society of record in the industry, they play no authoritative role over the practice of aesthetic medicine. They are a private company owned and governed by a dentist.
- Faculty transparency: AAFE typically lists “Dr.” instructors, however 97% of these are dentists, while eligibility and credentials in medical/nursing teaching contexts are unclear, especially in states where dentists cannot legally perform these injections.
- Accreditation: CME credits are aimed at dentists; medical/nursing CME validity is not clearly verifiable online.
- Class size dynamics: Class photos show 8–20 attendees with no published attendance cap per course date.
- Cost structure: Priced around $3,594 for a basic Toxin and Filler course that does not contain lip filler or low dilution Toxin techniques.
- Hands-on time per attendee: Difficult to tell, but at the class sizes pictured online, in addition to the time required to cover the necessary lecture material, that can leave as little 10 minutes of supervised injection per attendee due to the class sizes. Please call AAFE for more clarity on your maximum class size and hands-on time.
- Membership pressure: Multiple course “levels,” membership requirements, and titled credentials (e.g., “Master”) have no universally recognized status or value. Post-graduation training never needs a membership or renewal.
Conclusion
AAFE is a high-volume training provider with broad course location availability and dental-focused accreditation.
This training remains the gold standard for Dentists to learn from other dentists, but may be less competitive when training MD’s, DO’s and NP’s. The relationship between Dentists overseeing and training RN’s and NP’s is not clear. Read on for more detailed information and links…
How Does AAFE Botox Training Compare to Industry Standards?
| Item | Ideals for Botox and Filler Training for Physicians and Nurses | AAFE (facialesthetics.org) Botox and Filler Training |
|---|---|---|
| Faculty | Independent MD or NP with at least 10 years experience and licensed in the state they teach. The faculty must hold rank and be legal to supervise everyone they teach in the course. | 45 faculty are listed as “Dr.” and upon further research, 44 of them are Dentists. For non-dental classes the majority of the faculty appear to be employed nurses with limited (<5 years) experience and/or recent graduates of their own training classes who work in AAFE-branded clinics. Since the faculty teaching each date is not listed, one cannot check qualifications and licensure. |
| Accreditation | CME-accreditation for MD, DO, NP, PA, RN. CME joint sponsor named and independently verifiable online. | CME-accreditation for Dentists. CME-accreditation for medical and nursing professionals not readily verifiable online through the listed joint sponsor. |
| Class Size | Maximum 5 participants | 8–20+ participants common. Photos of classes often have more. No cap on class size listed online. |
| Cost and Payment Options | Complete but reasonably priced but less than $3,000. Pay-over-time options. | $3,297 with no pay-over-time options when adding to cart and reserving a class. |
| Hands-On Practice | Guaranteed product available for hands-on use under direct supervision by a faculty member who legally supervises the treatment. At least 30 minutes of dedicated one-on-one hands-on per attendee. | Product is included in tuition for level 1 training. Calculations based on class sizes shown in photos online and in social media could reduce the amount of hands-on contact time to well under 10 minutes per attendee. Since they do not list faculty present at each training, it is impossible to know how many supervising providers are at each training date. |
| Memberships and “Advanced Courses” | No paid memberships are needed or required. No renewals required. No advanced or higher-level training needed. No selling or pushing titles and certification “levels” that have no universally accepted meaning. | Emphasis on purchasing memberships and implying that certification must be renewed to continue practicing legally. Three levels of toxin and filler courses which cannot be taken in the same weekend or city, requiring a total cost over $10,000 and a minimum of 3 weekends of travel. Use of terms like “Master” does not have any legal status and is not a “Master’s degree”. |
AAFE is an abbreviation for
the “American Academy of Facial Esthetics” which can be found at the website facialesthetitics.org.
If you are interested in Botox and Filler Training, you have likely seen AAFE courses in Google Ads and on the first page of Google Search. But is this prominent placement justified and are they your best choice for one-stop aesthetic hands-on training as a Physician, PA or NP? We will review AAFE and compare to some training ideals and see if this may be the right option for you.
What is AAFE (facialesthetics.org)?
This organization is a dentist named Louis Maclmacher and his staff of employee nurses and contractor dentists who teach training courses in locations around the country.
They have leveraged SEO and backlinks to get to the top of Google rankings over the past decade. In the process, they have attempted to capitalize on their ambitious name and branch out beyond teaching other dentists, and attracting other professionals to train with them.
Who Teaches AAFE Courses?
That is a great question and one that AAFE refuses to answer on their website. For most dates, the faculty name and qualifications is not listed. There is no way to know if you be taught by a dentist or nurse and even if that person is legally licensed where they are conducting the training.
How Good is AAFE's Botox Training for Dentists?
Their botox training courses that are geared toward dentists are regarded as the best in the industry to teach the unique applications of botox to dentistry like treatment of TMJ. However, at least half of states to not consider the aesthetic practice of Botox to be germane to the practice of dentistry so no dentist on any faculty should be considered an expert in aesthetic indications
How Complete is AAFE's level 1 Training in Botox?
It is one of the least detailed courses of any provider. AAFE's business model is to price this incomplete course cheaply and force the attendee to take more time off and attend at a later date for an advanced course to learn very basic things like lip filler, which is hardly advanced at all.
Is an AAFE Master's Level Course like a Master's Degree?
Absolutely not. This is a misleading name and title that holds zero medical or legal status.
Are AAFE Courses Accredited?
Their courses have credit for dentists. Since dentists cannot teach or supervise nurses, PA's and MD's their education credits are also completely different. It is unclear which of AAFE's courses actually have accreditation for doctors and nurses from their website and emails to their CME provider for clarification go unanswered.
Is Hands-On Product included in the Tuition?
It is included for the basic course although exact amounts are not specified. For other "advanced" courses, please consult the agenda for each course carefully or call for clarification.
American Academy of Facial Esthetics (AAFE) – Detailed Review
An in-depth, evidence-based evaluation of AAFE (facialesthetics.org) compared to industry standards for physician and nurse Botox & filler training. This is a review of publicly available online information.
AAFE Ownership: Dentist plus possible non-medical investors.
1. 
CME Accreditation for MD, DO, NP, PA, RN’s
The word “certification” is used prominently by this training program, yet it has no formal legal meaning. It just means receipt of a piece of paper. The standard for post-graduate education is CME or CEU-accredited training that is peer reviewed and backed by an organization called a “joint sponsor” who is authorized to award AMA Category 1 Credits which are the only credits accepted for physicians, NP’s, PA’s and nurses. AAFE has CME credits through Pace for dentists which cannot be used by doctors and nurses. AAFE states that another organization backs their CME for doctors and nurses called “Medical Education Resources” however in three attempts to contact them to verify credit, they have not responded.
If you choose to attend AAFE, please check with Medical Education Resources regarding the validity of their CME credits for each class or “level” of training you plan to take. Also ask if any online portion has independent accreditation as an enduring material.
2. Faculty Qualifications and Transparency
While difficult to ascertain for any private company, AAFE appears to be controlled by a 68 year-old Dentist in Ohio named Louis Malcmacher. It is unknown who any other owners might be, or what percentage of ownership is non-medical. Dentists cannot legally perform cosmetic Botox and Filler in many US states since it is not considered germane to dental practice. In no US State jurisdiction do dentists supervise nurses in any procedure, yet they are supervising nurses and NP’s in these training environments.
It is impossible to know who is teaching any one given AAFE course offering as they never list the faculty for a given date and location. Therefore you will not know the qualifications of your instructor. However, scanning social media and other reviews, it appears that a small group of nurses and NP’s do the hands-on training that is not marketed with dental indications. This can be problematic for hands-on, because in most states, RN injectors require other higher-licensed providers to perform the patient evaluation exam. Some states also require supervision for NP’s as well. Also, anyone teaching a hands-on class must be licensed in the state of the class. Many traveling aesthetic faculty are not licensed where they teach so faculty transparency is crucial for potential attendees. This can be quite problematic for NP’s and MD’s taking the class as they may be considered responsible for the RN and any bad outcomes that may arise from hands-on.
It appears that this group of instructors are not from diverse experience backgrounds, but many also work for what appears to be an AAFE-operated medspa found in Ohio and in several other states. They have other “AAFE” branded medspas around the country with a single nurse or NP provider. It appears that the vast majority of the faculty trained at AAFE and have worked much or all of their careers with AAFE. Moreover, if those who work in AAFE-branded medspas also trained with AAFE, they may have no experience starting a business, hiring a medical director, and marketing as this was all provided by AAFE. Experience in starting and running a practice makes any faculty more credible to new trainees.
AAFE’s faculty page lists people who do not actively teach, with 98% of those identified as “Dr.” are really dentists. For a company that aggressively markets to medical providers, not just dentists, this could be misleading.
If you plan on registering for a AAFE class, please contact them first and ask for the name and degree of the instructor. Then go to the state nursing board website where the class is held and be certain that nurse has an active medical license in that state. Then if she does, do your due diligence on her experience level and history in the industry beyond involvement with AAFE.
Legally an RN cannot design a toxin or filler treatment in any state, which makes it difficult to teach hands-on. If your instructor is an RN, ask AAFE for who her supervising MD is that will be on-site approving these treatment designs.
A nurse with a multistate compact license can only function as an RN in other states. If she is an NP in her home state, that does not carry over to other states. There is no NP muti-state licensure.
3. Completeness of the First Level Course
It is difficult enough to calculate the cost of training when factoring in your time commitment and travel. However, when training is incomplete, or you have to purchase the product for hands-on (See Point 4 below), that makes it even harder.
The ideal training is to teach everything that is FDA-cleared and off-label indications that work in the level 1 course. This includes using the most concentrated dilution for Botox. Most people learn a 1cc dilution for a vial of toxin, yet AAFE considers this “advanced”. Looking at the limited information taught in Level 1, and the important basic information reserved for Level 2, it is apparent that their business model is to sell memberships and force people to take multiple courses (but at a “discount”) instead of being a one stop destination for great comprehensive training on the first contact date.
4. 
Transparency Regarding Hands-On Product Provided in Tuition Cost
AAFE has made great strides in this regard. A-T.com called out this organization in 2024 for not providing toxin and filler for hands-on at the live events and charging extra. They now supply a reasonable amount of toxin and filler to inject at live events. However, this comes at a steep price now putting their Level 1 (basic and incomplete) training in Botox and Fillers at a total cost of $3,297 which is the most expensive in the country by more than $400. And still they do not disclose who is teaching each class online.
5. Maximum Hands-On Class Size
Looking here it appears that the class can be quite large. Their website and social media show numerous photos of rooms with 10 or more providers in a class, some photos have 20-30 although it is unclear what is being taught at these events. This is too large for a 1-day training unless there are multiple faculty members and breakout hands-on sessions. They have no published cap for hands-on class size.
The ideal for a hands-on training course should be a cap of around 6 providers per instructor for the best hands-on treatment experience. If an organization has more demand, they should open more dates, not cram in additional attendees and dilute your experience for the same tuition cost.
If you are considering an AAFE training course, contact them for the maximum class size per qualified instructor for the city you are interested in attending first.
6. Location Transparency
It takes some digging to find the location for each training city. Some have incomplete addresses without suite numbers, some have no address at all.
If you are interested in attending and AAFE training course, contact them first for the actual street address for your hands-on.
AAFE is hosting more training programs in clinical facilities and these locations should be preferred to hotels, provided that your hands-on instructor is experienced enough to be worth your attendance.
7. 
No Fake Boards, Fake Society, or Membership Upsells
AAFE places significant emphasis on its membership model; however, prospective trainees should understand that continuing membership is not required to maintain the validity of completed training. Educational coursework, once completed, does not require renewal in order to remain part of one’s professional background. Training is distinct from licensure, and regulatory boards evaluate practitioners based on statutory requirements, not on affiliation with a private training organization.
AAFE’s marketing materials sometimes suggest that its name recognition or ongoing membership provides additional professional protection or standing. While branding may create perceived value, there is no evidence that affiliation with any single private training entity confers regulatory immunity or special recognition by medical or dental boards. Practitioners should verify independently what their specific state board requires, rather than relying on promotional claims.
It is also important to clarify that AAFE operates as a privately owned, for-profit training company. Unlike independent medical specialty societies, which are typically governed by diverse boards and operate through broadly recognized peer-driven standards, AAFE appears to be internally directed by its own leadership and faculty. Prospective students should understand this structural distinction when evaluating terms such as “academy” or “board.”
Membership renewals are not a regulatory requirement for maintaining prior aesthetic training, nor is aesthetic medicine itself a formally recognized specialty governed by a single national authority. As with any continuing education provider, AAFE’s role is to offer courses—not to function as a licensing or credentialing body.
Finally, some programs described as “accreditation” through AAFE are internal designations awarded to individuals who complete its own courses. These designations are not equivalent to accreditation by independent, third-party accrediting bodies. Prospective participants should review carefully what is being offered and assess whether the designation carries independent recognition beyond the issuing organization.
8. Offers a Blended Online plus Live Learning Environment
It appears that their Botox and Filler courses which are purchased separately but held on the same date have an online component and some online courses when purchased separately are CME approved.
It remains unclear if the exact online program bundled with the live hands-on has independent accreditation. For this to be accurate a Botox certificate would need to state 6 hours online and 4 hours of live CME properly broken down. We have been unable to independently verify the credit from their listed CME provider for non-dentists.
However, based on the class sizes seen in pictures, it would not be possible for that many people to have a proper review of the online material, Q&A, patient evaluations, and perform one-on-one treatments in under 4 hours for a Botox class and 4 hours for dermal filler class..
If you plan on registering for an AAFE training course, please be sure to ask the following questions regarding these blended online/live courses…
- Is there an online component to the course?
- How long do I have access?
- Is the online component independently accredited for CME/CEU and how many hours?
- What is the cap on hands-on class size.
- Please share a credit determination letter from Medical Education Resources and an example of the certificate given with the credit statement.
9. No Risk of Paid Models at the Live Training
In 2025, AAFE has shifted to a “bring your own model” plan, instead of recruiting patients from the community for the Level one courses. This is good development.
The ideal is that you treat someone known to you at hands-on and follow her results. This reduces the potential litigation risk of treating strangers, or worse, paid patients, at a hands-on training. Of course, these patients should be consented as patients of the faculty’s practice if they are being treated in her office.
One gray area is when you attend one of the AAFE branded clinics for training that are run by a local nurse who was trained by AAFE in the past. It is entirely possible that paying patients from these practices could be used or offered to attendees. If you offer to bring a friend or relative to receive your treatment, AAFE should allow this and not force you to use patients who pay AAFE to be there.
If you are considering AAFE, make sure you ask about the above issue if the training is at an AAFE Medspa. Otherwise, make sure that your faculty is experienced enough and duly licensed where the hands-on is located, and that they have the proper rank to supervise you in your hands-on.
10. General Transparency and Accessibility
When you enter into a teaching relationship, it should be collegial and not adversarial. The tone and language of the terms and conditions can give you a good idea of the corporate culture. They mention that a course is refundable … but a $997 fee applies.
Consider the value to you of extra levels of courses, and buying memberships and renewals that may not be required.
AAFE’s general position that dentists can supervise RN’s, NP’s, PA’s and MD’s in a hands-on training environment remains unique in the industry (although copied by Medaesthetictraining.com as well) and is not supported by by scope of practice or supervisory rules in any US state. Medical Providers supervise medical providers. Medical providers do not supervise hygienists and Dentists do not supervise nurses. This is from the Marti Law Group:
“Again, this can vary from state to state, but in nearly all cases, a dentist will need to hire a third-party Medical Director to oversee the clinical aspects and medical providers. The credentials of the Medical Director vary, but generally the individual will have to be a physician, nurse practitioner with independent practice authority, or in some instances, a physician assistant.”
Please use your judgment when attending a hands-on training supervised by a dentist, unless of course you are a dentist.
Please also use your own judgment when reading their reviews. Most tend to have a very similar format with names like “Dr. K.” and they often compliment the instructor by his/her first name. Please use your independent judgment about the validity of these reviews.