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? They have a robust social media presence and spend a lot of money behind the scenes to create relevancy to Google by paying for backlinks and for Google Ads. Of course, ultimately the customer bears these fees, but is AAFE a good value for MD’s, NP’s and RN’s? We will put AAFE to the test with our 50-point evaluation system. All information on this page is retrieved from items publicly available online.
Multi-Point Review of AAFE Botox Training
Each Category shall receive a weighted score depending on how well the training meets the standard.
Total Score: 20 out of 50 Points.
AAFE Ownership: Dentist plus non-medical investors.
1. CME Accreditation for MD, DO, NP, PA, RN’s (Score 5 (?) out of 10)
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 is dentist-run. They have 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.
2. Faculty Qualifications and Transparency (Score 3 out of 10)
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. In aesthetic circles he goes by “Dr. Malcmacher” which while factually correct, is misleading to make one believe he is an MD instead of a Dentist. Dentists cannot legally perform Botox and Filler in many US states since it is not considered germane to dental practice, yet he often introduces himself as a world-renowned expert in facial esthetics. He definitely knows more than most dentists, but it is still very misleading when they market heavily to MD’s, PA’s, NP’s and RN’s as well.
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 is apparent that a small group of nurses and NP’s do their hands-on training. 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. 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 also in Ohio. 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 most of their careers for AAFE. Therefore, it appears all Level 1 Botox and Filler courses are taught by RN’s and NP’s until proven otherwise. From watching some of their YouTube videos, it appears that the courses specifically highlighting dental indications may also be taught by dentists.
There has been a prior suit against AAFE and Malcmacher for hiring unqualified faculty who later got cited by the California Dental Board for performing treatments outside his scope of practice while teaching AAFE courses.
Another more recent suit is by a PDO Thread manufacturer accusing Malcmacher of misrepresentation and defamation while teaching for AAFE.
AAFE’s faculty page is littered with people who do not actively teach, with those identified as “Dr.” are dentists, with one doctor of nursing.
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.
3. Completeness of the First Level Course. (Score 3 out of 10)
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 standard here 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 high-priced 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. For more information please check out this video.
4. Transparency Regarding Hands-On Product Provided in Tuition Cost. (Score 1 out of 5)
Nowhere do they guarantee how much actual product you will get to inject under supervision. And worse, that product is NOT INLCUDED IN THE TUITION PRICE! Therefore you need to purchase more just to get your hands-on training. This is often a $500-$700 additional expense that trainees do not budget after purchasing the training. Here is their statement…
Product Cost
Cost of product is not included in course tuition. Additional material costs include $634 per vial of Botulinum Toxin, $317-$833 per box of dermal filler, and/or $10 – $68 per solid filler PDO thread. Prices are dependent on brand requested and are subject to change at any time. Products bought at the course are for use at the course only. Attendees may bring their own products but must show proof that they are original and authentic. A list of other necessary supplies will be provided for you to bring to the live patient course.
The industry standard is to provide a certain amount of toxin and filler for hands-on use UP FRONT and include it in the tuition price. At these prices, the product they expect you to buy is an additional profit center for them beyond your tuition payment.
5. Maximum Hands-On Class Size (0 out of 5)
Looking here it appears that the class can be as large as they want it to be with a single faculty instructor. Everywhere are photos of rooms with 10 or more providers in a class, some photos have 20-30. This is too large for a 1-day training.
The standard for a training course should be a cap of around 5-6 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.
6. Location Transparency (Score 2 out of 3)
It takes some digging to find the location for each training city. Some have incomplete addresses, some have no address at all.
7. No Fake Boards, Fake Society, or Membership Upsells (Score 0 out of 5)
This is where AAFE is one of the most over-marketed and misleading training sites out there. First, a “membership” has zero value. Training does not need to be renewed. Period. Training is not licensure. Furthermore, despite Malchmacher’s claims on YouTube and elsewhere that the “AAFE” name is well known by medical and dental board members and that training and ongoing membership will somehow protect you, this is also marketing fluff.
Furthermore, there is no Board or true Academy here. That would be made up of diverse individuals who are paid by AAFE but have no interest in AAFE and have trained elsewhere guiding AAFE’s leadership with their talents. That is simply not the case. AAFE’s instructors and leadership all seem to be local to them, and therefore, this is not an “academy”. They are simply imitating the nomenclature for naming real authorities in medical fields without actually being an authority.
Moreover, memberships, renewals and such are not required for any kind of training status over the long-term. Training is training. Aesthetics is not a medical specialty. AAFE is not an authority for an industry. And a Dentist is certainly not an authority for MD’s and NP’s. They are a for-profit training center, and an extensive lobbying organization to convince state dental boards to allow them to sell their training courses to dentists.
AAFE actually has the nerve to sell fake statuses that they call “accreditation” but are only open to people who paid to train with AAFE and completely run by AAFE. This is an outright scam. The status of paying to be a “diplomate” or “mastership” (what??) conveys NOTHING to you.
8. Offers a Blended Online plus Live Learning Environment (Score 4 out of 5)
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.
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..
9. No Risk of Paid Models at the Live Training (Score: 1 of 2)
You are paying a lot of money for this training. Once you pay for your product and pay extra for advanced courses and basic filler courses that others provide in “Level 1”, AAFE is one of the most expensive training providers out there.
When you treat someone who pays to be there, you establish a provider-patient relationship with them. You could get sued. And patients who pay for a treatment (not volunteer) have higher expectations and less tolerance for bad outcomes. Moreover, if your instructor is an RN and you are higher level, you are responsible for that outcome. Don’t take these risks.
AAFE recruits patient “volunteers” but it is unknown how much these patients are expected to pay. Please research this before you buy.
10. General Truthfulness and Accessibility (Score: 1 of 5)
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.
Using their customers as potential marks for additional profit from extra levels of courses, buying memberships and renewals that are not required.
Please 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. Buyer Beware here.
Final Score: 20 out of a possible 50
Final Recommendation… If you are a dentist and these procedures are in scope of practice in your state, then take an AAFE Botox course. Otherwise, you have better options.
