After our Aesthetic Injectable Foundations Courses, one of the most common questions we are asked is, “When can I come back for Advanced Class?” This seemingly simple question has a very complex and multi-layered answer—something that’s usually summed up by, ”it depends.”  It isn’t that we want to be vague, but it really is more of an honest self-assessment of your experience in aesthetic medicine. 


Take my own aesthetic medicine experience for example 

We have considered implementing a time frame at PNAA, but the experience in six months can be vastly different depending on how you practice, where you practice, and if applicable, with whom you practice. I will give myself as an example. My entry into the field of aesthetics after 27 years in trauma and emergency medicine was at a very small and not-so-busy medspa. I was the only medical provider on most of the days in which I worked and probably treated fewer than 10 clients a week. I was terrified each time a new client came in and I had to create a treatment plan. Because of this, I stuck mainly to neuromodulators in the glabella and frontalis, dermal filler only if the person asked for it, and I really lacked confidence. 

Back then, we just “chased lines and filled wrinkles” and I didn’t always love the results because I felt they looked unnatural. I was scared to death, especially if the filler treatment in question was lips. At the time, I had so little confidence in my abilities and often talked clients out of treatments that I was uncomfortable providing. Even though I worked almost a full 12 months at that spa, I would have been nowhere near ready for advanced training at the end of my first year in aesthetic medicine. 

Fast forward to my next job in a thriving, upscale plastic surgeon’s office. I literally treated around 100 clients a month and had great coaching and mentorship from my doctor. After three short months, I was gobbling up every advanced training I could get my hands on and learning new things all the time.  I was beyond ready for it.  


Making an honest assessment of your own experience 

So, you can see the contrast here and the point we are trying to make. Our answer goes back to that honest self-assessment. Are you relatively comfortable with the skills you learned in your foundational course? Don’t worry if the answer is no. You don’t need to tread water out there, hoping to “get it” eventually. We all reach that “ready for advanced” threshold differently.  

At PNAA, we offer several levels of training to meet you exactly where you are. We offer one-on-one refresher trainings and microcannula trainings that are geared toward the advanced beginner to the intermediate provider. From there, you can hone those skills and move towards more advanced injectable trainings and so much more! 

The field of aesthetics is constantly evolving with new products, services, and techniques.  When I started in this industry, we had a total of five FDA-approved fillers in the US. Ten years later, I really would have to count on my fingers and toes how many options we have, and I might run out of digits soon as more products come to market. To date, we have 18 FDA-approved fillers on the market. Additionally, we have bio stimulators, regenerative medicine, and PDO threads. Sometimes, it feels like new products are coming to market daily.  We have devices, skin treatments, and so many new ways to enhance natural beauty or restore the face to a more youthful appearance.  


Taking a course with PNAA means you’re family 

Once you have taken one of our courses, you become part of the PNAA family, and we are here to support you throughout your career and be a part of your journey by offering the right training for you at the right time. You have to crawl before you walk, and you have to walk before you run. 

I would be very leery of a training program that boasts teaching advanced skills in a basic training package. You can’t become a 5-year injector in one to three days. The good news is that a good foundation can be laid in those one to three days that you can build upon when you are ready and it is appropriate. We suggest you build your foundation to suit the direction you want to go in aesthetic medicine, whether that’s working at a medspa, a doctor’s office, or starting your own practice. You will have a different foundational approach depending upon the aesthetic medicine path you choose. Much like a home remodel, should your needs or career path change, you can broaden your foundation as needed.

What does it mean for consumers?

As a consumer, what does any of this have to do with you? First, let me say, there are injectors who leave our Foundations trainings that I would ten times rather have treatment from than many who have been in the industry for years. Don’t fret because your injector is new. If he or she is honest with you and admits what they don’t know, hallelujah! We all must start somewhere. The best injectors in the world were beginners at some point in their careers. I would be far more concerned by a 20-year injector who says, “I’ve been doing this for years, I really don’t need to learn anything new.”

I personally have invested tens of thousands of dollars into my own aesthetic medicine education over the last ten years and most of the top injectors in the nation will tell you the same. As I mentioned, with the evolution of products and techniques, had I relied on my initial training and clinical experience alone, I would probably be a decent injector, but I consider myself an excellent injector and that came with a lot of practice, a hunger to learn and stay up to date on the latest research and trends.


What’s the difference between continuing education and advanced training? 

Now, let’s talk about continuing education versus advanced training. Sounds like pretty much the same thing, right? It’s not. Most of us with medical licensure are required to have continuing education to maintain and renew our licenses. For example, in the state of Oregon, I must have seven hours of pain management training. That is mostly in response to the national opiate crisis and has almost nothing to do with my aesthetics practice. So if I tell you I have seven hours of continuing education, does that make me a better injector? Do you feel better about my skills? Absolutely not and you shouldn’t.  


Start by confirming licensure 

A savvy consumer should be asking his or her injector several questions. First, what is your licensure? It is astonishing to me that some physicians are still delegating the practice of aesthetics to medical assistants and other non-medical personnel with no formal training. If I mention the terms vascular occlusion, signs of tissue ischemia, impending necrosis, usually you will see their eyes glaze over because they don’t even know what those terms mean, much less how to assess for them or how to treat them.  

In Oregon, this is a very gray area. If the physician chooses a delegate in his or her practice, they are required to be on-site to double-check dosages of each injection prior to administration and be present to mitigate any potential complications should they arise. That is not happening in most cases. And guess what? Unlicensed medical personnel cannot be trained by pharmaceutical companies or any other reputable aesthetic training companies. Why? Because that would be considered the practice of medicine without a license and that is against the law in most states and/or very poorly defined in others.  

So, when that person tells you he or she is a highly trained Medical Assistant, they have only been trained in the office and have no ability to participate in any advanced trainings outside of the practice.  


Don’t forget about trainings 

The next question I would ask is “What aesthetic medicine trainings have you attended this year and what trainings are you planning to attend in the future?” A good injector is going to be super excited to tell you that they have attended at least one national conference this year, that they have had trainings with new product launches from the pharmaceutical companies, and that they are attending private trainings and seminars such as the enrichment curriculum at PNAA. 

That might include PRP, PDO threads, master classes, etc. We love to talk about the latest and greatest things we have learned! Most of us are complete anatomy geeks and would love to share our knowledge with you. The anatomy of aging and age-related treatments based on those anatomical changes is something I could talk about all day. If the blanket answer is, “I have the required 30 hours of CE to maintain my license,”  I would look for a new injector.  


Lastly, ask about their experience 

The last question I would ask is how long they have been injecting. Again, please don’t discount the novice injector. As a trainer of new injectors, I see hundreds of students annually and I will tell you, some injectors just have it, “the aesthetic eye.” It can be learned, but I can tell you, I know a truly gifted injector when I see one. I often tell new injectors that I will have confidence in them until they develop it for themselves. 

The primary reason I recommend you ask this question is that an honest new injector will tell you what skills they are confident and proficient in and what they aren’t.  In the next breath, they will tell you that they can’t wait for you to grow with them as they continue to learn. This is the kind of new injector I would have zero hesitancy working with. I would trust this person over the 20-year injector who has done little to nothing to expand their knowledge and skills.  “I’ve been doing it this way for 20 years and never had a problem,” might be the scariest answer of all!  


Trust PNAA for advanced training and continuing education in aesthetic medicine 

Continuing education is a mandate, advanced education is a choice. I say let’s all choose to be the best! We would love to help you develop your new career path, from your foundational training to your advanced training needs. And, don’t forget that online pain management course to maintain your licensure while you’re at it. It doesn’t take long, so you will have plenty of time to devote to the aesthetic medicine trainings that will set you apart from the rest.