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Establishment Labs Holdings
(NASDAQ:ESTA)
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Rating:41Neutral
Price Target:
$61.00
▼(-15.04% Downside)
Action:Reiterated
Date:09/07/26
The score is primarily constrained by still-negative profitability and cash flow (despite improving losses and strong gross margins), which weigh most heavily in the financial performance assessment. Technicals are mixed with neutral-to-soft momentum, and valuation is pressured by a negative P/E and no dividend yield provided. A positive board-level leadership addition provides a small offset but is not a primary driver of fundamentals.
Positive Factors
Revenue scale and gross margin
Meaningful revenue scale combined with a strong gross margin provides a solid economic foundation for the Motiva implant business. If growth continues, this margin profile can support commercial investment, operating leverage, and eventual progress toward sustainable profitability over the coming quarters.
Negative Factors
Still-negative profitability
Strong gross margins have not yet translated into positive operating or net earnings, showing that the company’s expense base still outweighs its current revenue contribution. Persistent losses can limit internally funded growth and leave future financial performance dependent on further scale, efficiency gains, and successful commercial execution.
Read all positive and negative factors
Positive Factors
Negative Factors
Revenue scale and gross margin
Meaningful revenue scale combined with a strong gross margin provides a solid economic foundation for the Motiva implant business. If growth continues, this margin profile can support commercial investment, operating leverage, and eventual progress toward sustainable profitability over the coming quarters.
Read all positive factors
Establishment Labs Holdings (ESTA) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$1.90B
Dividend YieldN/A
Average Volume (3M)330.69K
Price to Earnings (P/E)―
Beta (1Y)0.80
Revenue Growth38.55%
EPS Growth57.49%
CountryUS
Employees1,004
SectorHealthcare
Sector Strength45
IndustryMedical - Devices
Share Statistics
EPS (TTM)-1.31
Shares Outstanding29,801,891
10 Day Avg. Volume387,075
30 Day Avg. Volume330,690
Financial Highlights & Ratios
PEG Ratio0.99
Price to Book (P/B)91.68
Price to Sales (P/S)10.23
P/FCF Ratio-37.47
Enterprise Value/Market Cap1.46
Enterprise Value/Revenue11.30
Enterprise Value/Gross Profit16.03
Enterprise Value/Ebitda-300.83
Forecast
1Y Price Target
$102.13Price Target Upside42.24% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering8
EPS Forecast (FY)-1.2
Revenue Forecast (FY)$270.15M
Establishment Labs Holdings Business Overview & Revenue Model
Company Description
Establishment Labs Holdings Inc. operates as a medical technology enterprise specializing in the creation and commercialization of devices for aesthetic and reconstructive plastic surgery. The company is primarily recognized for its silicone gel-f...
How the Company Makes Money
Establishment Labs primarily makes money by selling breast implants and related surgical products to hospitals, clinics, and other healthcare providers (or through distributors) that perform aesthetic augmentation and reconstructive breast procedu...
Establishment Labs Holdings Earnings Call Summary
Earnings Call Date:May 06, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Nov 10, 2026
Earnings Call Sentiment Positive
The call communicated strong operational and commercial momentum led by a rapid U.S. launch, 45% YoY revenue growth in Q1, improving gross margin (70.7%) and a return to positive adjusted EBITDA. Key product innovations (minimally invasive platform) are driving adoption, surgeon and patient demand, and management raised full-year revenue guidance. Offsetting factors include elevated operating expenses, near-term cash usage and increased debt with PIK mechanics, plus some supply and geopolitical uncertainties. Overall, the positives around revenue acceleration, margin expansion, product differentiation and pathway to cash-flow positivity materially outweigh the risks discussed.Positive Updates
Strong Top-Line Growth
Q1 2026 revenue of $59.9M, up 44.7% YoY (management rounded to 45%), with full-year guidance raised to $266.5M–$268.5M (≈26%–27% growth vs. 2025).
Negative Updates
Cash Decline and Near-Term Cash Usage
Cash decreased $7.5M in Q1 to $68.1M; management expects higher cash usage in Q2 driven by a final $4.7M Benelux acquisition payment, short-term incentive payouts and continued U.S. commercial investments.
Read all updates
Q1-2026 Updates
Positive
Negative
Strong Top-Line Growth
Q1 2026 revenue of $59.9M, up 44.7% YoY (management rounded to 45%), with full-year guidance raised to $266.5M–$268.5M (≈26%–27% growth vs. 2025).
Read all positive updates
Company Guidance
Management raised full‑year revenue guidance to $266.5–$268.5 million (up from $264–$266M), implying ~26–27% growth versus 2025, after a strong Q1: $59.9M revenue (+44.7% YoY), U.S. revenue $19.6M (32.7% of Q1, +216% YoY), minimally invasive (MIS) revenue $9.1M in Q1 and MIS now expected to exceed $35M in 2026 (prior MIS guide $30M), and adjusted EBITDA of $1.2M in Q1 (third consecutive quarter of positive adjusted EBITDA). Full‑year gross margin is guided to 71.2–72.2% (Q1 GM 70.7%, +350 bps YoY), operating expenses $195–$200M, and management expects adjusted EBITDA to be positive each quarter and to be cash‑flow positive in H2 2026; cash was $68.1M at quarter end (down $7.5M), Q2 cash usage will be higher (including a $4.7M Benelux payment) but Q2 EBITDA is expected to be roughly double Q1, U.S. revenue is expected to exceed 30% of total for the year (vs ~22% in 2025) while OUS growth is expected in the single digits. They also refinanced debt (availability up to $265M from $225M, 8.75% rate with PIK optionality) and highlighted PIK interest benefit of more than $5M per quarter supporting near‑term cash flow.Establishment Labs Holdings Financial Statement Overview
Summary
Income Statement
34
Negative
Balance Sheet
46
Neutral
Cash Flow
28
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 245.82M | 211.08M | 166.03M | 165.15M | 161.70M | 126.68M |
| Gross Profit | 173.27M | 146.31M | 109.53M | 106.98M | 106.59M | 85.40M |
| EBITDA | -9.23M | -22.29M | -56.22M | -58.31M | -56.73M | -26.53M |
| Net Income | -38.89M | -51.06M | -84.60M | -78.50M | -75.21M | -41.14M |
Balance Sheet | ||||||
| Total Assets | 351.93M | 357.17M | 346.83M | 268.64M | 211.06M | 139.53M |
| Cash, Cash Equivalents and Short-Term Investments | 71.16M | 75.57M | 90.35M | 40.03M | 66.36M | 53.41M |
| Total Debt | 263.67M | 264.47M | 225.29M | 192.22M | 179.35M | 54.21M |
| Total Liabilities | 330.32M | 333.62M | 293.74M | 250.25M | 219.25M | 88.79M |
| Stockholders Equity | 21.61M | 23.55M | 53.09M | 18.39M | -8.19M | 50.74M |
Cash Flow | ||||||
| Free Cash Flow | -42.06M | -57.61M | -74.08M | -113.06M | -86.43M | -34.26M |
| Operating Cash Flow | -32.72M | -50.89M | -58.52M | -88.51M | -52.17M | -27.53M |
| Investing Cash Flow | -9.29M | -7.03M | -15.61M | -24.55M | -34.79M | -7.16M |
| Financing Cash Flow | 58.42M | 40.43M | 125.89M | 86.23M | 100.25M | 4.05M |
Establishment Labs Holdings Technical Analysis
Negative
71.80
Price Trends
73.03
Negative
78.10
Negative
73.06
Negative
Market Momentum
-2.91
Positive
31.34
Neutral
32.24
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For ESTA, the sentiment is Negative. The current price of 71.8 is above the 20-day moving average (MA) of 66.91, below the 50-day MA of 73.03, and below the 200-day MA of 73.06, indicating a bearish trend. The MACD of -2.91 indicates Positive momentum. The RSI at 31.34 is Neutral, neither overbought nor oversold. The STOCH value of 32.24 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for ESTA.
Establishment Labs Holdings Risk Analysis
Establishment Labs Holdings disclosed 66 risk factors in its most recent earnings report. Establishment Labs Holdings reported the most risks in the "Legal & Regulatory" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Establishment Labs Holdings Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
71 Outperform | $806.19M | 11.26 | 11.80% | ― | -6.71% | -50.25% | |
66 Neutral | $1.32B | 24.35 | 5.51% | 0.45% | 3.86% | -48.06% | |
58 Neutral | $2.24B | -27.75 | -38.36% | ― | 28.14% | -5.15% | |
57 Neutral | $2.11B | -53.62 | -17.88% | 22.22% | 23.57% | -543.50% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
44 Neutral | $1.01B | -145.44 | -0.69% | ― | 1.60% | 98.56% | |
41 Neutral | $1.90B | -46.33 | -203.88% | ― | 38.55% | 57.49% |
* Healthcare Sector Average
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Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.