dismissed EB-2 NIW Case: Aesthetic Medicine

U.S. Citizenship 
and Immigration 
Services 
Non-Precedent Decision of the
Administrative Appeals Office 
Date: APR. 11, 2024 In Re: 30636626 
Appeal of Texas Service Center Decision 
Form 1-140, Immigrant Petition for Alien Workers (National Interest Waiver) 
The Petitioner, a surgeon in aesthetic medicine, seeks employment-based second preference (EB-2) 
immigrant classification as a member of the professions holding an advanced degree, as well as a 
national interest waiver of the job offer requirement attached to this classification. See Immigration 
and Nationality Act (the Act) section 203(b )(2), 8 U.S.C. § 1153(b )(2). 
The Director of the Texas Service Center denied the petition, concluding that the record did not 
establish the Petitioner's eligibility for the requested national interest waiver. The matter is now before 
us on appeal. 8 C.F.R. § 103.3. 
The Petitioner bears the burden of proof to demonstrate eligibility by a preponderance of the evidence. 
Matter ofChawathe , 25 I&N Dec. 369, 375-76 (AAO 2010). We review the questions in this matter 
de novo. Matter of Christo 's, Inc., 26 I&N Dec. 537, 537 n.2 (AAO 2015). Upon de novo review, 
we will dismiss the appeal. 
I. LAW 
To establish eligibility for a 
national interest waiver, a petitioner must first demonstrate qualification 
for the underlying EB-2 visa classification as either an advanced degree professional or an individual 
of exceptional ability in the sciences, arts, or business. Section 203(b )(2)(B)(i) of the Act. An 
advanced degree is any United States academic or professional degree or a foreign equivalent degree 
above that of a bachelor' s degree. A United States bachelor's degree or foreign equivalent degree 
followed by five years of progressive experience in the specialty is the equivalent of a master's degree. 
8 C.F.R. § 204.5(k)(2). If, however, a doctoral degree is customarily required by the profession, a 
noncitizen must have a United States doctorate or a foreign equivalent degree . Id. 
Once a petitioner demonstrates eligibility for the underlying EB-2 classification, they must then 
establish that they merit a discretionary waiver of the job offer requirement "in the national interest." 
Section 203(b )(2)(B)(i) of the Act. While neither the statute nor the pertinent regulations define the 
term "national interest," Matter of Dhanasar, 26 I&N Dec. 884, 889 (AAO 2016), provides the 
framework for adjudicating national interest waiver petitions. Dhanasar states that U.S. Citizenship 
and Immigration Services (USCIS) may, as matter of discretion 1, grant a national interest waiver if 
the petitioner demonstrates that: 
• The proposed endeavor has both substantial merit and national importance; 
• The individual is well-positioned to advance their proposed endeavor; and 
• On balance, waiving the job offer requirement would benefit the United States. 
II. ANALYSIS 
The Director determined that the Petitioner qualifies as an advanced degree professional but failed to 
establish eligibility for a national interest waiver under the Dhanasar framework. For the reasons set 
forth below, we agree that the Petitioner is not eligible for a national interest waiver under the 
Dhanasar framework and dismiss the appeal. 
The first Dhanasar prong, substantial merit and national importance, focuses on the specific endeavor 
that the individual proposes to undertake. Dhanasar, 26 I&N Dec. at 889. The endeavor's merit may 
be demonstrated in a range of areas such as business, entrepreneurialism, science, technology, culture, 
health, or education. Id. In determining whether the proposed endeavor has national importance, we 
consider its potential prospective impact. Id. We agree with the Director's conclusion that the 
proposed endeavor has substantial merit as the endeavor falls within the range of areas we concluded 
could demonstrate an endeavor of substantial merit: health. Id. Yet, we also agree that the Petitioner 
has not demonstrated the national importance of his proposed endeavor under the first prong of the 
Dhanasar analytical framework. 
The Petitioner intends to work in the United States as a surgeon and physician in aesthetic and 
regenerative medicine. Initially the Petitioner stated he planned to "appl[y] his clinical knowledge in 
aesthetic medicine by providing comprehensive services to underrepresented populations within the 
United States, particularly ... individuals who have been subject to gender-based violence and 
survivors of firearms related damage." In support of this endeavor, the Petitioner submitted a personal 
statement, various industry reports and articles discussing the impact of foreign national doctors to the 
U.S. health care industry and national initiatives aimed at combating the shortage of qualified 
physicians, along with support letters discussing the Petitioner's expertise as a surgeon and in the 
aesthetic medicine field. 2 The Petitioner asserted that the record established his proposed endeavor 
was "national in scope, [because it would] produce significant national benefits, due to the ripple 
effects of his professional activities ... [ and] contribute to tax revenue, generate jobs for U.S. workers, 
and ultimately increase the flow of money in the U[ nited] S [ tat es]." The Petitioner did not submit a 
business plan with the initial filing, and consequently did not provide details as to how he planned to 
execute his endeavor. 
In response to the Director's request for evidence (RFE), the Petitioner submitted a newly created five­
year business plan for a Florida-based aesthetic medicine services company, indicating he would serve 
1 See Flores v. Garland, 72 F.4th 85, 88 (5th Cir. 2023) (joining the Ninth, Eleventh, and D.C. Circuit Courts (and Third 
in an unpublished decision) in concluding that USCIS' decision to grant or deny a national interest waiver to be 
discretionary in nature). 
2 While we do not discuss each piece of evidence contained in the record individually, we have reviewed and considered 
each one. 
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as the company's scientific director. The business plan described the aesthetic-medicine services the 
company would provide, including "facial cleansing, premium facial cleansing, facial dermonutrition 
with Dermapen, Botulinum toxin (Botox), hyaluronic acid application, and RF (radio frequency) 
treatments for women and men." In addition, through this company, the Petitioner now indicated he 
planned to "provide training courses in laser surgery and procedures to physicians and plastic 
surgeons." According to the business plan, "the petitioner strives to contribute to a higher quality of 
life of American patients." The plan explained that this endeavor is of national importance because 
of the growing demand for aesthetic-medicine services, which in tum can improve the confidence, 
self-esteem, and quality of life for their patients. The Petitioner also submitted an expert opinion letter 
in response to the Director's RFE, which generally concluded the Petitioner's endeavor has national 
importance due to the rapid growth in the aesthetic medicine industry and the Petitioner's expertise, 
which would allow him to meet this demand of clients. 
After acknowledging the submission of the new evidence, including the business plan and expert 
opinion letter, the Director denied the petition, concluding that the Petitioner did not establish his 
endeavor has national importance under the first prong of the Dhanasar framework. Specifically, the 
Director concluded that the record did not support the Petitioner's assertions that his endeavor would 
have broader implications to the aesthetic medicine field or the United States, or otherwise result in 
other substantial positive economic effects as contemplated under the first prong of the Dhanasar 
analytical framework. 
On appeal, the Petitioner generally asserts that the Director did not apply the correct burden of proof 
and failed to properly consider the evidence on record that established both his experience in the field 
as well as the impact of his proposed business endeavor. The Petitioner also asserts the Director erred 
in disregarding the expert opinion letter solely because the expert had not established their expertise 
as it relates to INA § 203(b )(2)(B). 
The standard of proof in this proceeding is a preponderance of the evidence, meaning that a petitioner 
must show that what is claimed is "more likely than not" or "probably" true. Matter ofChawathe, 25 
I&N Dec. at 375-76. To determine whether a petitioner has met the burden under the preponderance 
standard, we consider not only the quantity, but also the quality (including relevance, probative value, 
and credibility) of the evidence. Id.; Matter ofE-M-, 20 I&N Dec. 77, 79-80 (Comm'r 1989). Upon 
a de novo review of the record, we see no error in the Director's evaluation of the evidence, as it does 
not establish, by a preponderance of the evidence, that the Petitioner's proposed endeavor has national 
importance as contemplated under the Dhanasar framework. 
The Petitioner asserts that the Director erred by not fully considering the business plan which he 
contends establishes the national importance of the endeavor given the services he plans to offer. 
Specifically, the Petitioner notes that the business plan mentions he will provide reconstructive surgery 
to bum victims "to allow these individuals to recover physically and emotionally from this traumatic 
experience... [ and] treat patients from all over the United States, which ... is in the national interest 
of the U[nited] S[tates]." And the business plan elaborated on the Petitioner plans to provide training 
to plastic surgeons and physicians. Yet, while these services may speak to the merit of the endeavor, 
they do not establish its national importance. We would also note that the business plan contains 
inconsistencies regarding the offerings of the company. In the first section, the plan indicates the 
company will offer the aesthetic services listed above. These are also the only offerings referenced in 
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the business plan's sales forecasts for the company's initial five years of operation, even though it also 
indicates that the company will hire a plastic surgeon to perform reconstructive surgery for bum 
victims, and otherwise discusses the impact of plastic surgery. As such, it is not apparent from the 
business plan how much time, if any, the company will dedicate to offering reconstructive surgery 
services to bum victims or other individuals. Regardless, the Petitioner has not addressed the 
Director's conclusion that any benefits from the Petitioner's endeavor do not appear to extend beyond 
his immediate patients or potential trainees to result in broader implications to the field. In Dhanasar, 
we determined that the petitioner's teaching activities did not rise to the level of having national 
importance because they would not impact his field more broadly. Id. at 893. Here too, the record 
does not show that the Petitioner's proposed endeavor stands to sufficiently extend beyond his 
potential patients to impact the aesthetic medicine or healthcare field or U.S. economy more broadly 
at a level commensurate with national importance. 
Moreover, while the author described their own experience within the medical field, the expert opinion 
letter did not discuss any broader implications that would be attributable to the Petitioner's specific 
endeavor, instead relying solely on the importance of the aesthetic medicine field generally and the 
Petitioner's professional experience to support their conclusion that the proposed endeavor has 
national importance. When evaluating the national importance of a proposed endeavor, the relevant 
question is not the importance of the industry or profession in which the individual will work. Instead, 
we focus on the "the specific endeavor that the foreign national proposes to undertake." Id. at 889. In 
addition, a petitioner's expertise and record of success in previous positions are considerations under 
Dhanasar' s second prong, which does not evaluate the prospective impact of an endeavor, but instead 
"shifts the focus from the proposed endeavor to the foreign national." Id. 
Here, much of the letter's content lacked relevance and probative value with respect to the national 
importance of the proposed endeavor. While we may use expert opinion letters submitted by the 
Petitioner as advisory testimony, we are responsible for making the final determination regarding 
eligibility for the benefit sought. Matter ofCaron Int'!, 19 I&N Dec. 791, 795 (Comm'r. 1988). The 
submission of letters from experts supporting the petition is not presumptive evidence of eligibility. 
Id., see also Matter ofD-R-, 25 I&N Dec. 445, 460 n.13 (BIA 2011) (discussing the varying weight 
that may be given expert testimony based on relevance, reliability, and the overall probative value). 
As such, the Director's alleged error in disregarding the expert opinion letter is, at most, harmless. 
See generally Matter ofO-R-E-, 28 I&N Dec. at, 350 n.5 (citing Japarkulova v. Holder, 615 F.3d 696, 
701 (6th Cir. 2010) (stating that error is harmless where there is no "reason to believe that ... remand 
might lead to a different result" (citation omitted))). 
We also agree with the Director that the Petitioner has not established that the endeavor would have a 
"a significant potential to employ U.S. workers" or otherwise reach the level of "substantial positive 
economic effects" contemplated by Dhanasar. Dhanasar at 890. The business plan states that the 
company intends to employ a total of 12 employees within the first five years of operations, with a 
total payroll expense of $762,443. The Petitioner also anticipates total sales of $1,069,942 in the first 
five years of operations. However, the business plan provides no explanation for the basis of these 
projections. On appeal, the Petitioner asserts that the Director's "singular focus on employee numbers 
and sales figures is misplaced," yet the Petitioner has not otherwise established how the endeavor 
would result in direct economic benefits that would rise to the level of national importance. Even if 
the endeavor's revenue and job creation projections were more than conjecture, they do not establish 
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that the endeavor would operate on a scale rising to the level of national importance, as the Petitioner 
has not explained how these proposed employment numbers and revenue will impact the area of 
intended operations, nor has he provided evidence that his business operations will impact an 
economically depressed area. And that is the Petitioner's burden to meet. Matter of Chawathe, 25 
I&N Dec. 369, 375-76 (AAO 2010). 
For all the reasons discussed, the evidence does not establish the national importance of the proposed 
endeavor as required by the first prong of the Dhanasar precedent decision. 
III. CONCLUSION 
Because the identified reason for dismissal is dispositive of the Petitioner's appeal, we decline to reach 
and hereby reserve the Petitioner's remaining arguments concerning eligibility under the Dhanasar 
framework. See INS v. Bagamasbad, 429 U.S. 24, 25 (1976) (stating that "courts and agencies are not 
required to make findings on issues the decision of which is unnecessary to the results they reach"); 
see also Matter ofL-A-C-, 26 I&N Dec. 516, 526 n. 7 (BIA 2015) ( declining to reach alternative issues 
on appeal where an applicant is otherwise ineligible). 
ORDER: The appeal is dismissed. 
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