Establishment Labs Holdings (ESTA) AI Stock Analysis

• Market Cap: $1.43B
• Dividend Yield: N/A
• Average Volume (3M): 306.15K
• Price to Earnings (P/E): ―
• Beta (1Y): 1.20
• Revenue Growth: 24.76%
• EPS Growth: -10.41%
• Country: US
• Employees: 1,034
• Sector: Healthcare
• Sector Strength: 45
• Industry: Medical - Devices
• EPS (TTM): -0.38
• Shares Outstanding: 28,970,736
• 10 Day Avg. Volume: 370,691
• 30 Day Avg. Volume: 306,149
• PEG Ratio: 6.73
• Price to Book (P/B): 24.44
• Price to Sales (P/S): 7.81
• P/FCF Ratio: -17.51
• Enterprise Value/Market Cap: 0.99
• Enterprise Value/Revenue: 7.96
• Enterprise Value/Gross Profit: 11.83
• Enterprise Value/Ebitda: -25.81
• 1Y Price Target: $57.33
• Price Target Upside: 16.05% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 6
• EPS Forecast (FY): N/A
• Revenue Forecast (FY): N/A

• Rating: 58 Neutral
• Price Target: $68.00 ▲(37.65% Upside)

The overall stock score is primarily influenced by the strong earnings call, which highlights significant revenue growth and positive EBITDA. However, financial performance concerns, including high debt levels and negative cash flows, weigh heavily on the score. Technical analysis shows bullish momentum, but valuation metrics are weak due to negative earnings.

Positive Factors

Revenue Growth

The significant revenue growth indicates strong market demand and effective sales strategies, enhancing the company's market position and long-term growth prospects.

Positive EBITDA

Achieving positive EBITDA marks a critical milestone, reflecting improved operational efficiency and potential for sustainable profitability.

Market Expansion

Robust growth in European markets underscores the company's successful international expansion strategy, supporting long-term revenue diversification.

Negative Factors

High Debt Levels

The high debt levels pose a risk to financial stability, potentially limiting the company's ability to invest in growth opportunities and affecting long-term sustainability.

Negative Cash Flows

Negative operating cash flows indicate challenges in generating sufficient cash from operations, which may impact liquidity and financial flexibility.

Rising Operating Expenses

Increasing operating expenses can erode profit margins and hinder the company's ability to achieve sustainable profitability, affecting long-term financial health.

Establishment Labs Holdings Business Overview & Revenue Model

Company Description

Establishment 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 Money

Establishment 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 Financial Statement Overview

Summary

Establishment Labs Holdings is experiencing revenue growth but faces significant challenges with profitability and financial stability. High debt levels and negative cash flows are concerning, indicating a need for strategic adjustments to improve financial health.

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.

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.

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.

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	231.12M	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

• Technical Analysis Sentiment: Positive
• Last Price: 49.40
• 50DMA: Positive
• 100DMA: Positive
• 200DMA: Positive
• MACD: Negative
• RSI: Negative
• STOCH: Neutral

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 49.4 is above the 20-day moving average (MA) of 49.37, above the 50-day MA of 43.65, and above the 200-day MA of 38.82, indicating a bullish trend. The MACD of 3.91 indicates Negative momentum. The RSI at 80.32 is Negative, neither overbought nor oversold. The STOCH value of 73.84 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for ESTA.

Establishment Labs Holdings Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
INMD	71 Outperform	$1.02B	5.89	25.91%	―	-13.98%	15.94%
CNMD	66 Neutral	$1.41B	12.91	11.69%	1.80%	4.64%	-51.57%
BVS	66 Neutral	$624.23M	-1,020.27	4.97%	―	1.58%	―
AORT	62 Neutral	$2.19B	―	-5.01%	―	7.44%	-109.83%
ESTA	58 Neutral	$1.43B	-16.14	-338.19%	―	24.76%	-10.41%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
SSII	44 Neutral	$1.46B	―	-43.42%	―	159.43%	67.42%

Establishment Labs Holdings Corporate Events

Establishment Labs Reports Strong Q3 2025 Growth

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 science and technology solutions.

Establishment Labs Reports Record Growth and Positive Outlook

The recent earnings call of Establishment Labs Holdings painted a picture of strong performance and optimism for the future. The company reported significant achievements in revenue growth, gross margin improvement, and achieving positive EBITDA for the first time. Despite facing challenges such as tariff impacts and rising operating expenses, the company’s robust growth in key markets, particularly the U.S. and Europe, and its strategic focus on innovation and market expansion, suggest a promising outlook.

Establishment Labs’ Adaptive Study on Gluteal Augmentation: Key Insights for Investors

Study Overview: Establishment Labs Holdings is conducting an adaptive study titled ‘Adaptive Study to Assess the Initial Safety and Functioning of the Minimally Invasive Gluteal Augmentation Procedure and Its Devices in Participants Undergoing Primary Gluteal Enhancement.’ This study aims to evaluate the safety and performance of various Motiva devices used in minimally invasive gluteal augmentation for 120 healthy female participants. The significance lies in understanding the potential side effects, device functionality, and satisfaction levels of both surgeons and participants.

Establishment Labs Amends Credit Agreement with Oaktree

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

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

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.