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Establishment Labs Holdings (ESTA)
:ESTA
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Establishment Labs Holdings
(NASDAQ:ESTA)
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Rating:48Neutral
Price Target:
$39.00
▼(-0.28% Downside)
The overall stock score reflects significant financial challenges, including high debt and negative cash flows, which weigh heavily on the score. Positive earnings call highlights, such as revenue growth and improved EBITDA, provide some optimism but are offset by valuation concerns and technical neutrality.
Positive Factors
Revenue Growth
The consistent revenue growth indicates strong market demand and effective sales strategies, supporting long-term business expansion and stability.
Market Expansion
The significant growth in European markets enhances Establishment Labs' global footprint, diversifying revenue streams and reducing regional dependency.
Product Innovation
Innovative products like Preservé strengthen the company's competitive edge, potentially commanding premium pricing and expanding market share.
Negative Factors
High Debt Levels
High debt levels pose financial risks, potentially limiting the company's ability to invest in growth opportunities and affecting long-term financial health.
Negative Cash Flows
Negative cash flows indicate potential liquidity issues, which could hinder operational flexibility and necessitate strategic financial adjustments.
Challenges in China
Underperformance in China limits growth potential in a key market, requiring strategic initiatives to overcome market-specific challenges and achieve desired expansion.
Establishment Labs Holdings (ESTA) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$1.21B
Dividend YieldN/A
Average Volume (3M)288.21K
Price to Earnings (P/E)―
Beta (1Y)1.14
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. Volume240,560
30 Day Avg. Volume288,213
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 Cap1.17
Enterprise Value/Revenue7.96
Enterprise Value/Gross Profit11.83
Enterprise Value/Ebitda-25.81
Forecast
1Y Price Target
$55.25Price Target Upside41.27% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering8
Establishment Labs Holdings Business Overview & Revenue Model
Company DescriptionEstablishment 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 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 11, 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
Negative
39.11
Price Trends
40.04
Negative
39.27
Negative
38.21
Positive
Market Momentum
0.23
Negative
47.85
Neutral
70.60
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 39.11 is below the 20-day moving average (MA) of 39.47, below the 50-day MA of 40.04, and above the 200-day MA of 38.21, indicating a neutral trend. The MACD of 0.23 indicates Negative momentum. The RSI at 47.85 is Neutral, neither overbought nor oversold. The STOCH value of 70.60 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 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
Overall Rating
UnderperformOutperform
Sector (51)
Financial Indicators
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
76 Outperform | 1.04B | 5.99 | 28.44% | ― | -3.62% | 40.68% | |
74 Outperform | 1.50B | 13.70 | 10.99% | 1.74% | 4.02% | 11.32% | |
55 Neutral | 1.93B | -94.07 | -4.27% | ― | 7.44% | -109.83% | |
53 Neutral | 569.66M | -913.51 | -0.10% | ― | 5.08% | 99.38% | |
49 Neutral | 1.13B | -89.26 | -46.43% | ― | 135.60% | 66.47% | |
48 Neutral | $1.21B | ― | -261.18% | ― | 17.22% | 1.65% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% |
* Healthcare Sector Average
Performance Comparison
ESTA
Establishment Labs Holdings
39.11
-7.93
-16.86%
CNMD
Conmed
45.99
-27.75
-37.63%
AORT
Artivion
40.43
13.58
50.58%
INMD
InMode
14.78
-2.65
-15.20%
SSII
SS Innovations International
5.65
1.89
50.27%
BVS
Bioventus
6.76
-4.88
-41.92%
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.