ANCP (Asociacion Nicaraguense de cirugia plastica y reconstructiva) ALLERGAN medical institute ASPS (AMERICAN SOCIETY OF PLASTIC SURGEONS) FELICE academy FILACP (Federación Ibero Latinoamericana de Cirugía Plástica) Hospital Bautista Hospital Vivian Pellas HRET(Hybrid rhinoplasty excellence trainning) IMCAS (International Master Course on Aging Skin) Ipras (International Confederation for Plastic, Reconstructive & Aesthetic Surgery) POLYTECH UNAN (universidad nacional autonoma de nicaragua) otros