Establishment Labs Holdings Inc. operates as a medical technology enterprise specializing in the creation and commercialization of devices for aesthetic and reconstructive ...
Establishment Labs Holdings Inc. (NASDAQ: ESTA) is a global medical technology company dedicated to improving women’s health and wellness, with an initial and primary focus on breast aesthetics and reconstructive care. The company’s core commercial portfolio centers on silicone gel-filled breast implants marketed under the Motiva Implants brand, including models ...Establishment Labs Holdings Inc. (NASDAQ: ESTA) is a global medical technology company dedicated to improving women’s health and wellness, with an initial and primary focus on breast aesthetics and reconstructive care. The company’s core commercial portfolio centers on silicone gel-filled breast implants marketed under the Motiva Implants brand, including models such as Motiva Ergonomix and Motiva Ergonomix2. These implants are characterized as gravity-sensitive, round, soft silicone-gel-filled devices intended to support aesthetic outcomes and patient safety.
Beyond implants, Establishment Labs also offers adjacent solutions used in the broader clinical workflow. Its product set includes the Motiva Flora Tissue Expander for breast tissue expansion, which is relevant in reconstructive pathways. In addition, the company distributes the Puregraft range of products used for the harvesting and redistribution of autologous adipose tissue, extending the company’s presence into procedures that leverage a patient’s own tissue.
From a commercialization standpoint, the company sells its offerings across multiple regions—including Europe, Latin America, and the Asia-Pacific region—using a combination of a direct sales force and exclusive distributors. This hybrid go-to-market model supports both direct physician/surgeon engagement and scalable regional distribution, which is important in medical device markets where surgeon adoption and regulatory/market access are critical.
Operationally, the company reports having roughly ~1,000 full-time employees (about 1004). Financially, the latest provided TTM snapshot indicates challenging profitability: margins are negative across EBIT/operating/net measures (e.g., net profit margin around -0.158), with negative returns on assets and equity. Valuation multiples also reflect this (negative earnings-based metrics such as P/E). Liquidity indicators appear relatively strong on a current ratio basis (current ratio ~3.84, with a quick ratio ~2.52), suggesting the company’s near-term liquidity position is not the primary constraint in the provided dataset. Working-capital figures and cash conversion cycle data are also provided, with a longer conversion cycle, which is consistent with medical device manufacturing and distribution dynamics.
Key leadership includes Peter Caldini (Fillipo/Peter Caldini), appointed CEO effective May 7, 2025 after serving as Interim CEO earlier in 2025. Overall, Establishment Labs’ strategic “wish list” as a medical device manufacturer typically includes: expanding surgeon adoption of its core implant lines, broadening access to reconstructive and adjunct products, strengthening international distribution effectiveness, and improving profitability through operating leverage, product mix optimization, and continued execution against regulatory and commercialization milestones.
YoYYoY means Year-over-Year. It compares the latest annual value with the previous annual value to show long-term trend strength.
QoQQoQ means Quarter-over-Quarter. It compares the latest quarter with the immediately previous quarter to show short-term momentum changes.
RevenueThe total money that came through the front door from selling things, before paying a single bill. Think of it as the grand total of every credit card swipe from customers. (YoY compares this year to last year's performance, while QoQ compares the current three months to the previous three).
$211.1M
+27.1%
+12.8%
Net IncomeThe absolute bottom line. If the company paid every single supplier, employee, banker, and tax collector, this is the actual money left in their pocket at the end of the day.
$-51.1M
+39.6%
+12.2%
Gross MarginThe basic markup. If they sell a $100 pair of sneakers, this percentage tells you how much of that price tag is profit right after paying for the rubber and shoelaces, but before paying for things like store rent or TV commercials.
+69.3%
+5.1%
-0.1%
Operating MarginThe 'day job' efficiency score. Out of every dollar a customer spends, this shows how many cents the company keeps after making the product AND paying for all the everyday corporate overhead (like salaries, marketing, and keeping the lights on).
-18.5%
+38.6%
+41.6%
Net MarginThe final take-home percentage. When you strip away every conceivable cost, tax, and interest payment, this is the exact number of cents the company truly gets to keep from every dollar in sales.
-24.2%
+52.5%
+22.2%
Free Cash FlowThe holy grail of corporate cash. It's the spendable, physical money left over after the business pays for its daily operations AND buys the big, expensive upgrades (like new factories or servers) it needs to survive. This is the 'free' money they can use to pay dividends or buy back stock.
$-57.6M
+22.2%
-221.4%
FCF MarginThe ultimate cash conversion rate. It shows how good the company is at turning regular sales directly into cold, hard, spendable cash. A high percentage means the business is an absolute cash-printing machine.
-27.3%
+38.8%
-184.9%
Debt / EquityThe financial risk gauge. It compares how much of the company's empire was built using borrowed money (loans) versus the owners' own money (shareholders). A high number means they are heavily leveraged and playing a riskier game; a low number means they are playing it safe.
1123.1%
+164.7%
-31.7%
Current RatioThe 12-month survival check. It simply compares the cash they have right now (plus things they can quickly turn into cash) against the immediate bills they absolutely must pay this year. A score above 1 means they have enough in the wallet to cover the upcoming bills without panicking.
3.04x
-14.5%
+29.8%
Total AssetsThe absolute size of the company's empire. It bundles together absolutely everything of value they own—from the cash in the register and the inventory in the warehouse, to the software patents in the vault and the factories on the ground.
Operator: Good morning. Welcome to Establishment Labs First Quarter 2026 Earnings Call. [Operator Instructions] As a reminder, today's call is being recorded. I will now turn the call over to Malavika William, Global Head of Corporate Communications and Marketing. Please go ahead.
Malavika William: Thank you, operator, and thank you, everyone, for joining us. With me today is Peter Caldini, our Chief Executive Officer; and Sandra Harris, our Chief Financial Officer. Following our prepared remarks, we'll take your questions. Before we begin, I would like to remind you that comments made by management during this call will include forward-looking statements within the meaning of federal securities law. These include statements of Establishment Labs' financial outlook and the company's plans and timing for product development and sales. These forward-looking statements are based on management's current expectations and involve risks and uncertainties. For a discussion of the principal risk factors and uncertainties that may affect our performance or cause actual results to differ materially from these statements, I encourage you to review our most recent annual and quarterly reports on Form 10-K and Form 10-Q as well as other SEC filings, which are available on our website at establishmentlabs.com. I'd also like to remind you that our comments may include certain non-GAAP financial measures with respect to our performance, including, but not limited to, sales results, which can be stated on a constant currency basis or EBITDA, which we disclose on an adjusted EBITDA basis. Reconciliations to comparable GAAP financial measures for non-GAAP measures, if available, may be found in today's press release, which is available on our website. The content of this conference call contains time-sensitive information accurate only as of the date of this live broadcast, May 6, 2026. Except as required by law, Establishment Labs undertakes no obligation to revise or otherwise update any statement to reflect events or circumstances after the date of this call. With that, it is my pleasure to turn the call over to Peter.
Filippo Caldini: Good morning, and thank you for joining us. Q1 2026 was a strong start to the year with $59.9 million in revenue and adjusted EBITDA of $1.2 million, representing revenue growth of 45% over Q1 2025. The U.S. business continued to outperform with $19.6 million of revenue, a growth of 216% over Q1 2025 and quarter-over-quarter growth of 13.3%. It's worth noting that Q1 is a seasonally light quarter for breast augmentation and reconstruction, so to grow quarter-over-quarter is a testament to the strength and acceleration of our U.S. launch. Outside the U.S., we delivered 15% growth, driven by strong execution on both our direct and distributor markets. Our minimally invasive platform is showing immense promise as well, generating $9.1 million in revenue in Q1. At the same time, we had our third quarter of positive adjusted EBITDA. …