Establishment Labs Holdings (ESTA) AI Stock Analysis

• Market Cap: $995.33M
• Dividend Yield: N/A
• Average Volume (3M): 422.21K
• Price to Earnings (P/E): ―
• Beta (1Y): 1.32
• Revenue Growth: 9.27%
• EPS Growth: 1.51%
• Country: US
• Employees: 1,034
• Sector: Healthcare
• Sector Strength: 42
• Industry: Medical - Devices
• EPS (TTM): -0.70
• Shares Outstanding: 28,917,253
• 10 Day Avg. Volume: 297,285
• 30 Day Avg. Volume: 422,215
• PEG Ratio: 2.98
• Price to Book (P/B): 27.65
• Price to Sales (P/S): 0.00
• P/FCF Ratio: -15.03
• Enterprise Value/Market Cap: 0.98
• Enterprise Value/Revenue: 1.53
• Enterprise Value/Gross Profit: 8.68
• Enterprise Value/Ebitda: -4.33
• 1Y Price Target: $54.00
• Price Target Upside: 58.96% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 8

• Rating: 57 Neutral
• Price Target: $36.00 ▲(5.98%Upside)

Establishment Labs Holdings' score is driven by strong revenue growth and strategic leadership changes, but tempered by financial instability and ongoing losses. Technical analysis shows mixed signals, and valuation metrics reflect current financial challenges. The company's future profitability and market expansion are key to improving its score.

Positive Factors

Financial Performance

ESTA's preliminary 1Q results exceeded Street expectations, with a total revenue of $41.4M.

Trade Relations

Easing of the trade war reduces concern about ESTA's international business, making it a more attractive investment.

US Launch

Strong US Motiva launch metrics show that ESTA is rapidly gaining access to plastic surgery centers across the country.

Negative Factors

International Business

Analyst is concerned that the US launch may not be enough to offset macro headwinds in the international business.

Revenue Growth

Revenue growth slowed to 11% in 1Q25 from 41% in 4Q24.

Establishment Labs Holdings Business Overview & Revenue Model

Company Description

Establishment Labs Holdings Inc., a medical technology company, manufactures and markets medical devices for aesthetic and reconstructive plastic surgery. The company primarily offers silicone gel-filled breast implants under Motiva Implants brand name. It also provides Motiva Ergonomix and Motiva Ergonomix2 gravity sensitive round soft silicone-gel-filled breast implants; and Motiva Flora Tissue Expander, a breast tissue expander, as well as distributes Puregraft line of products for autologous adipose tissue harvesting and redistribution. The company sells its products through exclusive distributors and direct sales force in Europe, Latin America, the Asia-Pacific, and internationally. Establishment Labs Holdings Inc. was incorporated in 2004 and is headquartered in Alajuela, Costa Rica.

How the Company Makes Money

Establishment Labs makes money primarily through the sale of its Motiva Implants, which are distributed to plastic surgeons and healthcare facilities worldwide. The company generates revenue by marketing and selling these implants directly or through a network of distributors in various international markets. A significant portion of its earnings is derived from regions where there is a high demand for cosmetic surgery, such as Latin America, Europe, and Asia. Establishment Labs also invests in research and development to innovate and expand its product offerings, which can lead to increased sales and market share. Strategic partnerships and collaborations with healthcare providers and industry experts further enhance its market presence and contribute to revenue growth.

Establishment Labs Holdings Financial Statement Overview

Summary

Establishment Labs Holdings demonstrates strong revenue growth but struggles with profitability and financial stability. The company maintains a high gross profit margin but continues to report significant net losses. Debt levels have been reduced, which is positive, but the low equity base remains a concern. Cash flow from operations is negative, indicating reliance on external financing. Overall, the company faces challenges in achieving sustainable profitability and improving its financial stability.

Income Statement

The company has shown a consistent increase in revenue over the years, with a revenue growth rate of 2.53% from 2024 to TTM 2025. However, profitability remains a challenge, as indicated by the negative EBIT and net profit margins. The gross profit margin for TTM 2025 is relatively healthy at 66.34%, but the net income is deeply negative, leading to a net profit margin of -52.34%. The EBIT and EBITDA margins are also negative, indicating operational inefficiencies.

Balance Sheet

The balance sheet shows a high level of liabilities relative to equity, with a debt-to-equity ratio of 0.10 in TTM 2025, which is significantly lower than previous years, indicating reduced leverage. However, the company has a low return on equity (ROE) due to its negative net income. The equity ratio is low at 11.56% in TTM 2025, suggesting limited equity financing. The financial stability is a concern given the company's high liabilities and minimal equity.

Cash Flow

Cash flow analysis indicates negative free cash flow, though it has shown some growth with a free cash flow growth rate of 7.57% from 2024 to TTM 2025. The operating cash flow to net income ratio is less meaningful due to negative values for both metrics. The company relies heavily on financing activities to fund its operations, which could pose risks if financing becomes constrained.

Breakdown
TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement		Total Revenue
170.24M	166.03M	165.15M	161.70M	126.68M	84.68M
	Gross Profit
112.95M	109.53M	106.98M	106.59M	85.40M	52.50M
	EBIT
-58.10M	-49.99M	-65.03M	-39.66M	-25.14M	-27.92M
	EBITDA
-63.20M	-56.22M	-58.31M	-56.90M	-26.54M	-24.93M
	Net Income Common Stockholders
-89.10M	-84.60M	-78.50M	-75.21M	-41.14M	-38.12M
Balance Sheet		Cash, Cash Equivalents and Short-Term Investments
77.95M	90.35M	40.03M	66.36M	53.41M	84.52M
	Total Assets
152.35M	346.83M	268.64M	211.06M	139.53M	156.39M
	Total Debt
51.94M	225.29M	192.22M	178.66M	53.81M	51.76M
	Net Debt
-26.02M	134.95M	152.19M	112.31M	391.00K	-32.77M
	Total Liabilities
79.80M	293.74M	250.25M	219.25M	88.79M	81.43M
	Stockholders Equity
72.55M	53.09M	18.39M	-8.19M	50.74M	74.96M
Cash Flow		Free Cash Flow
-69.53M	-64.63M	-113.06M	-86.43M	-34.26M	-16.42M
	Operating Cash Flow
-68.12M	-58.52M	-88.51M	-52.17M	-27.53M	-12.51M
	Investing Cash Flow
-10.33M	-15.61M	-24.55M	-34.79M	-7.16M	-5.56M
	Financing Cash Flow
76.23M	125.89M	86.23M	100.25M	4.05M	64.67M

Establishment Labs Holdings Technical Analysis

• Technical Analysis Sentiment: Negative
• Last Price: 33.97
• 50DMA: Negative
• 100DMA: Negative
• 200DMA: Negative
• MACD: Positive
• RSI: Neutral
• STOCH: Positive

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 33.97 is below the 20-day moving average (MA) of 35.35, below the 50-day MA of 34.39, and below the 200-day MA of 39.44, indicating a bearish trend. The MACD of 0.45 indicates Positive momentum. The RSI at 46.13 is Neutral, neither overbought nor oversold. The STOCH value of 15.80 is Positive, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for ESTA.

Establishment Labs Holdings Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
INVA	73 Outperform	$1.26B	89.44	-8.84%	―	17.90%	-133.73%
PCRX	63 Neutral	$1.22B	―	-12.27%	―	3.08%	-247.82%
ESTA	57 Neutral	$995.33M	―	-186.68%	―	9.27%	1.51%
Sector *	53 Neutral	$5.24B	3.28	-44.98%	2.81%	16.82%	-0.32%
NEO	52 Neutral	$936.90M	―	-8.57%	―	10.10%	8.79%
OPK	51 Neutral	$1.08B	―	-3.04%	―	-13.79%	82.82%
KMTS	34 Underperform	$1.16B	―		―	―	―

Establishment Labs Holdings Corporate Events

Establishment Labs Holds Annual Shareholder Meeting

On May 23, 2025, Establishment Labs Holdings held its Annual Meeting of Shareholders, where three key proposals were voted on. The election of directors saw Juan Jose Chacón Quirós, Ann Custin, Nicholas Lewin, Edward Schutter, and Bryan Slotkin elected to serve until the 2026 meeting. Additionally, the compensation of the named executive officers was approved on an advisory basis, and the appointment of CBIZ, CPAs P.C. as the independent registered public accounting firm for the fiscal year ending December 31, 2025, was ratified.

The most recent analyst rating on (ESTA) stock is a Buy with a $48.00 price target. To see the full list of analyst forecasts on Establishment Labs Holdings stock, see the ESTA Stock Forecast page.

Establishment Labs Appoints Filippo Caldini as CEO

On May 6, 2025, Establishment Labs Holdings Inc. appointed Filippo ‘Peter’ Caldini as the Chief Executive Officer, effective May 7, 2025, following an extensive search process. Caldini, who has been serving as the interim CEO since March 2025, will also join the Board of Directors as a Class II director. This leadership change is expected to drive the company’s strategic goals, including achieving EBITDA positive status in 2025 and cash flow positive in 2026, as the company continues to innovate and expand its market presence, particularly with its upcoming launch in the United States.