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Establishment Labs Holdings Inc (ESTA)
NASDAQ:ESTA
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Establishment Labs Holdings
(NASDAQ:ESTA)
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Rating:49Neutral
Price Target:
$49.00
▼(-1.71% Downside)
The overall stock score is primarily influenced by financial performance challenges, including high debt and negative cash flows. Technical analysis shows strong bullish momentum, but valuation concerns due to negative earnings impact the score. Positive earnings call sentiment is noted but not weighted.
Positive Factors
Revenue Growth
The consistent revenue growth indicates strong market demand and successful product adoption, which is crucial for long-term business sustainability and expansion.
Product Innovation
The introduction of innovative products like Preservé enhances the company's competitive edge, potentially leading to increased market share and premium pricing.
Market Expansion
Strong growth in European markets demonstrates successful international expansion, diversifying revenue streams and reducing reliance on any single market.
Negative Factors
High Debt Levels
Significant financial leverage poses risks to financial stability, potentially limiting the company's ability to invest in growth opportunities and manage economic downturns.
Negative Cash Flows
Negative cash flows can strain liquidity and hinder the company's ability to fund operations and growth initiatives, impacting long-term financial health.
Profitability Challenges
Ongoing profitability issues highlight operational inefficiencies and cost management challenges, which could affect the company's ability to sustain growth and investor confidence.
Establishment Labs Holdings (ESTA) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$1.37B
Dividend YieldN/A
Average Volume (3M)306.15K
Price to Earnings (P/E)―
Beta (1Y)1.22
Revenue Growth17.22%
EPS Growth1.65%
CountryUS
Employees1,034
SectorHealthcare
Sector Strength45
IndustryMedical - Devices
Share Statistics
EPS (TTM)-0.57
Shares Outstanding28,970,736
10 Day Avg. Volume370,691
30 Day Avg. Volume306,149
Financial Highlights & Ratios
PEG Ratio6.73
Price to Book (P/B)24.44
Price to Sales (P/S)7.81
P/FCF Ratio-17.51
Enterprise Value/Market Cap1.03
Enterprise Value/Revenue7.96
Enterprise Value/Gross Profit11.83
Enterprise Value/Ebitda-25.81
Forecast
1Y Price Target
$57.33Price Target Upside15.01% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering6
Establishment Labs Holdings Business Overview & Revenue Model
Company DescriptionEstablishment Labs Holdings (ESTA) is a global medical technology company specializing in innovative solutions for the aesthetic and reconstructive surgery markets, particularly in breast aesthetics. The company is known for its flagship product line of silicone breast implants, which are designed to enhance both the safety and aesthetic outcomes for patients. In addition to breast implants, Establishment Labs develops and markets a range of complementary products and services that support surgeons and enhance patient care in the cosmetic and reconstructive surgery fields.
How the Company Makes MoneyEstablishment Labs generates revenue primarily through the sale of its silicone breast implants and related products to healthcare professionals and surgical centers. The company operates a direct sales model and has established a network of distributors globally, which helps in reaching a wider customer base. Key revenue streams include the sale of implants, ancillary products, and educational services for surgeons. Establishment Labs also benefits from partnerships with healthcare providers and institutions that facilitate the adoption of its products. Furthermore, the company invests in research and development to innovate and expand its product offerings, contributing to its competitive edge and potential revenue growth.
Establishment Labs Holdings Earnings Call Summary
Earnings Call Date:Aug 07, 2025
(Q2-2025)
| % Change Since: |
Next Earnings Date:Nov 05, 2025
Earnings Call Sentiment Positive
The earnings call reflects a positive outlook with strong revenue growth and successful market penetration in the U.S. and Europe. However, challenges in the Chinese market and increased operating expenses present some concerns.Q2-2025 Updates
Positive Updates
Revenue Growth and Guidance Increase
Revenue in the second quarter totaled $51.3 million, a growth of 16% over last year. The company raised its revenue guidance to $208 million to $212 million, representing a growth of 25% to 28%.
Improvement in Operating Profitability
Adjusted EBITDA loss for the quarter was $8.5 million, an improvement from the $12.1 million in the first quarter. Cash use fell to $14.5 million from $21.2 million last quarter.
U.S. Market Success
U.S. sales in the second quarter were $10.3 million, exceeding expectations. The company reached 1,000 accounts in the U.S. and expects U.S. revenue to exceed $40 million.
European Market Growth
European direct market sales increased by approximately 27% this quarter, reflecting a new sales record.
Introduction of Preservé
Preservé, an advanced breast enhancement technique, received positive reception from U.S. surgeons, and the company expects it to command a premium.
Awards and Recognition
The Motiva Flora SmoothSilk Tissue Expander won both the Innovation and Safety Awards in the 2025 Medical Device Network Excellence Awards.
Negative Updates
Challenges in China
The business in China is performing below expectations due to market environment challenges and slower scaling of commercial operations.
Higher Operating Expenses
Operating expenses for the second quarter increased by approximately $11.1 million from the year-ago period, driven by higher shipping costs and marketing expenses.
Company Guidance
During Establishment Labs' Second Quarter 2025 Earnings Call, the company reported a revenue of $51.3 million, which reflects a 16% growth over the previous year. The U.S. operations contributed $10.3 million, surpassing the anticipated range of $9.5 million to $10 million. This robust performance has led Establishment Labs to raise its full-year revenue guidance to between $208 million and $212 million, indicating a growth projection of 25% to 28%. In terms of profitability, the company improved its adjusted EBITDA loss to $8.5 million from $12.1 million in the first quarter, while cash usage reduced to $14.5 million from $21.2 million. Establishment Labs continues to bolster its market position, particularly in the U.S., where it has reached over 1,000 accounts, and is experiencing notable sales growth in its European direct markets, which saw an increase of approximately 27%. Despite challenges in China, the company remains optimistic about achieving a leadership position there. Establishment Labs aims to achieve its first positive EBITDA quarter later in the year and anticipates being cash flow breakeven by 2026.Establishment Labs Holdings Financial Statement Overview
Summary
Establishment Labs Holdings shows modest revenue growth but struggles with profitability and financial stability. High debt levels and negative cash flows are concerning, indicating a need for strategic adjustments.Income Statement
Establishment Labs Holdings has shown a modest revenue growth rate of 4.22% in the TTM period, indicating some positive momentum. However, the company is struggling with profitability, as evidenced by negative net profit margins and EBIT margins. The gross profit margin remains relatively strong at 67.24%, suggesting efficient production processes, but the overall profitability is hindered by high operating expenses.45
Neutral
Balance Sheet
The balance sheet reveals significant financial leverage with a high debt-to-equity ratio of 9.86 in the TTM period, indicating potential risk in terms of financial stability. The return on equity is negative, reflecting ongoing losses and challenges in generating shareholder value. The equity ratio is low, suggesting a heavy reliance on debt financing.30
Negative
Cash Flow
Cash flow analysis shows a slight improvement in free cash flow growth, but the company continues to face negative operating cash flows, which could impact its liquidity position. The operating cash flow to net income ratio is negative, indicating that the company is not generating sufficient cash from its operations to cover its net losses.40
Negative
| Breakdown | TTM | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 | Dec 2020 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 177.42M | 166.03M | 165.15M | 161.70M | 126.68M | 84.68M |
| Gross Profit | 119.29M | 109.53M | 106.98M | 106.59M | 85.40M | 52.50M |
| EBITDA | -54.68M | -56.22M | -58.31M | -56.90M | -26.54M | -24.93M |
| Net Income | -88.52M | -84.60M | -78.50M | -75.21M | -41.14M | -38.12M |
Balance Sheet | ||||||
| Total Assets | 329.67M | 346.83M | 268.64M | 211.06M | 139.53M | 156.39M |
| Cash, Cash Equivalents and Short-Term Investments | 54.64M | 90.35M | 40.03M | 66.36M | 53.41M | 84.52M |
| Total Debt | 224.50M | 225.29M | 192.22M | 178.66M | 54.21M | 52.54M |
| Total Liabilities | 306.90M | 293.74M | 250.25M | 219.25M | 88.79M | 81.43M |
| Stockholders Equity | 22.76M | 53.09M | 18.39M | -8.19M | 50.74M | 74.96M |
Cash Flow | ||||||
| Free Cash Flow | -71.80M | -74.08M | -113.06M | -86.43M | -34.26M | -16.42M |
| Operating Cash Flow | -72.69M | -58.52M | -88.51M | -52.17M | -27.53M | -12.51M |
| Investing Cash Flow | -7.99M | -15.61M | -24.55M | -34.79M | -7.16M | -5.56M |
| Financing Cash Flow | 79.39M | 125.89M | 86.23M | 100.25M | 4.05M | 64.67M |
Establishment Labs Holdings Technical Analysis
Positive
49.85
Price Trends
40.90
Positive
40.71
Positive
38.09
Positive
Market Momentum
2.32
Negative
72.66
Negative
96.84
Negative
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For ESTA, the sentiment is Positive. The current price of 49.85 is above the 20-day moving average (MA) of 42.84, above the 50-day MA of 40.90, and above the 200-day MA of 38.09, indicating a bullish trend. The MACD of 2.32 indicates Negative momentum. The RSI at 72.66 is Negative, neither overbought nor oversold. The STOCH value of 96.84 is Negative, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for ESTA.
Establishment Labs Holdings Risk Analysis
Establishment Labs Holdings disclosed 62 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 |
|---|---|---|---|---|---|---|---|
79 Outperform | $1.11B | 6.32 | 25.91% | ― | -3.62% | 40.68% | |
74 Outperform | $1.40B | 12.76 | 11.69% | 1.64% | 4.02% | 11.32% | |
55 Neutral | $588.67M | ― | -0.10% | ― | 5.08% | 99.38% | |
53 Neutral | $2.01B | ― | -5.01% | ― | 7.44% | -109.83% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
49 Neutral | $1.37B | ― | -261.18% | ― | 17.22% | 1.65% | |
48 Neutral | $1.92B | ― | -39.11% | ― | 135.60% | 66.47% |
* Healthcare Sector Average
ESTA
Establishment Labs Holdings
49.85
4.98
11.10%
CNMD
Conmed
48.77
-12.69
-20.65%
AORT
Artivion
43.47
16.86
63.36%
INMD
InMode
15.59
-2.11
-11.92%
SSII
SS Innovations International
9.57
5.57
139.25%
BVS
Bioventus
7.11
-6.24
-46.74%
Establishment Labs Holdings Corporate Events
Business Operations and StrategyPrivate Placements and Financing
Establishment Labs Amends Credit Agreement with Oaktree
Positive
Oct 3, 2025
On September 29, 2025, Establishment Labs Holdings Inc. amended its Credit Agreement with Oaktree Fund Administration, allowing for the immediate availability of Tranche D Term Loans and increasing the required minimum liquidity from $25 million to $30 million. The company fully borrowed $25 million under the new terms, which could enhance its financial flexibility and support its operational strategies.
The most recent analyst rating on (ESTA) stock is a Hold with a $42.00 price target. To see the full list of analyst forecasts on Establishment Labs Holdings stock, see the ESTA Stock Forecast page.
Establishment Labs Reports Strong Growth Amid Challenges
Aug 13, 2025
The recent earnings call for Establishment Labs Holdings painted a picture of optimism tempered by challenges. The company reported strong revenue growth, particularly in the U.S. and European markets, alongside improved operating profitability. However, these positive developments were offset by difficulties in the Chinese market, increased operating expenses, and setbacks in the Asia Pacific region.
Establishment Labs Reports Strong Q2 2025 Revenue Growth
Aug 8, 2025
Establishment Labs Holdings Inc. is a global medical technology company focused on enhancing women’s health and wellness, particularly in breast aesthetics and reconstruction, through innovative scientific and technological solutions.
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.