For aesthetic injections there is neither a dedicated specialist title nor an additional qualification (Zusatzbezeichnung) – and yet there is a clear path into the field. This guide shows which requirements apply, in which order you should learn, what the training costs and what must be clarified before your first treatment of your own.
Physicians may administer botulinum toxin and hyaluronic acid fillers; the licence to practise medicine is sufficient. In 2011, the Federal Constitutional Court (Bundesverfassungsgericht) clarified that it entitles its holder to treat in all fields it covers. Specialist training is not required for this – what is owed, however, is treatment in accordance with the specialist standard of care. Anyone who injects must therefore be able to do what is expected of a specialist.
The law on specialist medical training does not provide for a separate training qualification in “Aesthetic Medicine”. Surgical aesthetic procedures form part of specialist training in plastic, reconstructive and aesthetic surgery. For minimally invasive procedures such as botulinum toxin and fillers, the qualification is acquired in practice through structured continuing education and experience under supervision. Private certificates and part-time degree programmes can supplement this but are not a legal requirement.
Different rules apply to dentists, Heilpraktiker (non-medical practitioners) and beauticians. They are set out, with statutes and court rulings, in the guide Who may inject Botox and hyaluronic acid?.
| Step | What you learn | Suitable course |
|---|---|---|
| 1 · Anatomy | Vessels, nerves, muscles and fat compartments of the face – the basis of every injection | Facial anatomy – basic course (online) |
| 2 · Botulinum toxin | Active substance and preparations, dosage, the classic indications of the upper face | Botulinum toxin basic course (online) |
| 3 · First injections | Facial analysis, treatment plan and injection on a model under supervision | Botox course in Düsseldorf or fundamentals course |
| 4 · Hyaluronic acid fillers | Preparations, injection planes, lips and midface | Hyaluronic acid course for doctors |
| 5 · Complications | Recognising vascular occlusion, using hyaluronidase, emergency plan | Complication management |
| Alongside · 1:1 mentoring | Individual training on your topics – for getting started or for individual techniques, at your pace | 1:1 training & mentoring |
This is followed by routine and consolidation: the lower third of the face, biostimulation, combination treatments. Case discussions in the physicians' community help you to put your own results into perspective. The order is a recommendation – what matters is that you have a firm grasp of the anatomy before the first injection and that you begin with a small number of indications.
| Topic | What matters |
|---|---|
| Professional liability insurance | Aesthetic treatments are not covered by every policy. Have the cover for the specific procedures confirmed to you in writing. |
| Patient information and consent | The less a procedure is medically indicated, the more detailed the information given to the patient must be – including on rare risks, in writing and in good time before the treatment. |
| Documentation | Record findings, preparation, batch, quantity and areas; standardised photos before the treatment. |
| Emergency equipment | Anyone who injects hyaluronic acid keeps hyaluronidase to hand and has a plan for vascular occlusion. |
| Billing and tax | Elective services, too, are billed according to the German medical fee schedule (GOÄ). Services without a medical indication are generally subject to VAT – please clarify this with your tax adviser. Fee codes and rules can be found in the guide Billing Botox and hyaluronic acid under the GOÄ. |
| Advertising | Prescription-only medicines such as botulinum toxin may not be advertised to laypersons. Following the judgment of the Federal Court of Justice (BGH) of 31 July 2025, before-and-after pictures are not permitted for injection treatments. |
Overview, as of October 2026. It does not replace legal or tax advice.
There is no such thing as a “specialist in aesthetic medicine” (“Facharzt für ästhetische Medizin”). Anyone who uses this designation without having completed corresponding recognised specialist training misleads patients – this was the ruling of the Higher Regional Court of Hamm (OLG Hamm) on 12 May 2026 (4 UKl 3/25; leave to appeal on points of law has been granted). That case concerned information given by a chatbot on a provider's website: whoever operates it is liable for this too.
Even the designation “Arzt für Ästhetische Medizin” (“physician for aesthetic medicine”) was assessed as misleading by the Higher Regional Court of Frankfurt am Main (OLG Frankfurt am Main) on 22 January 2026 in the case of a specialist in general medicine, because a considerable proportion of those addressed would see it as a specialist title; the physician must counteract this misconception by providing clarification (6 U 362/24; not final according to information from the Wettbewerbszentrale of February 2026).
You are on the safe side if you state your actual qualification and describe your activity instead of forming a title – for example your own specialist title together with the treatments offered. Course certificates document continuing education; they do not confer a designation. In case of doubt, the legal department of your State Chamber of Physicians (Ärztekammer) can help. More on this in the guide Additional qualification in aesthetic medicine: what may I call myself?.
The MEDEMIE online courses are available for a one-off payment with permanent access; the prices are stated on the respective course pages. The fee for the hands-on workshops depends on scope and supervision and is stated in the respective course announcement.
You learn most economically if you work through the theory online and use the in-person time for practice. What the price of a course depends on and what costs arise in addition to the course fee is explained in the guide What does a Botox course for doctors cost?. You can find all courses under Aesthetics courses for doctors.
Through structured continuing education: first anatomy and one procedure in theory, then injections under supervision in the hands-on workshop, followed step by step by further procedures and complication management. A dedicated specialist title or an additional qualification (Zusatzbezeichnung) is not provided for this.
No. Legally, the licence to practise medicine is sufficient. In terms of liability, however, the treatment must meet the specialist standard of care – regardless of which specialist training you have.
Caution: on 22 January 2026, the Higher Regional Court of Frankfurt am Main (OLG Frankfurt am Main) assessed this designation as misleading in the case of a specialist in general medicine (6 U 362/24, not final). According to the Higher Regional Court of Hamm (OLG Hamm; 12 May 2026, 4 UKl 3/25), “Facharzt für ästhetische Medizin” (“specialist in aesthetic medicine”) is misleading because this specialist title does not exist. It is better to state your actual qualification and describe your activity.
The law on specialist medical training does not provide for an additional training qualification in “Aesthetic Medicine”. Surgical aesthetic procedures form part of specialist training in plastic, reconstructive and aesthetic surgery. For injection treatments, the training consists of courses, hands-on training and supervised practice.
Legally yes, the licence to practise medicine is sufficient. Clarify secondary employment with your employer as well as your insurance cover, and gain your first experience under supervision.
Many start with botulinum toxin because the number of indications is manageable, and then add hyaluronic acid fillers. The foundation for both is facial anatomy.
The theory, yes: anatomy, active substances, indications and techniques can be worked through online at your own pace. Injecting can only be learned in practice – on a model and under supervision.
The theory can be worked through in a few weeks. Confidence comes with practice: first a few indications under supervision, then treatments of your own, then gradually more. How quickly this happens depends on the number of treatments.
The prices of the online courses are stated on the respective course pages, the fee for the hands-on workshops in the course announcement. What the price depends on is explained in the guide What does a Botox course for doctors cost?.
Aesthetics courses for doctors: all courses with prices
View →OverviewBotox course for doctors: online and hands-on
View →OverviewHyaluronic acid course for physicians: fillers online and hands-on
View →GuideHow do you recognise a good Botox or filler course?
Read →GuideWhat does a Botox course for doctors cost?
Read →GuideWho may inject Botox and hyaluronic acid? The legal position in 2026
Read →OnlineBotox course online: basic and advanced course
View →Hands-onFundamentals course: botulinum toxin and hyaluronic acid in one day
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