Establishment Labs Holdings Inc (ESTA)
NASDAQ:ESTA
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Establishment Labs Holdings
(NASDAQ:ESTA)
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Rating:58Neutral
Price Target:
$75.00
▲(11.81% Upside)
Action:Reiterated
Date:05/09/26
The score is held back primarily by weak financial performance driven by ongoing net losses and persistent cash burn. Offsetting this, the earnings call was strong with raised guidance, accelerating growth (especially in the U.S.), and improving margins/adjusted EBITDA, while technicals are supportive. Valuation is constrained by negative earnings and no dividend.
Positive Factors
Revenue growth & U.S. launch traction
Sustained high single- to double-digit revenue growth with rapid U.S. adoption materially expands the addressable market and diversifies geography. Durable U.S. traction reduces dependence on slower OUS markets and supports scalable unit volumes and long-term revenue base as the company commercializes Motiva.
Negative Factors
Persistent negative cash flow
Ongoing negative operating and free cash flow signals continued cash burn that will require external financing or strict execution to reach break-even. This structural cash shortfall constrains strategic optionality, increases refinancing risk, and places a hard timeline on achieving sustainable cash conversion.
Read all positive and negative factors
Positive Factors
Negative Factors
Revenue growth & U.S. launch traction
Sustained high single- to double-digit revenue growth with rapid U.S. adoption materially expands the addressable market and diversifies geography. Durable U.S. traction reduces dependence on slower OUS markets and supports scalable unit volumes and long-term revenue base as the company commercializes Motiva.
Read all positive factors
Establishment Labs Holdings (ESTA) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$1.94B
Dividend YieldN/A
Average Volume (3M)510.67K
Price to Earnings (P/E)―
Beta (1Y)1.07
Revenue Growth34.86%
EPS Growth52.13%
CountryUS
Employees1,034
SectorHealthcare
Sector Strength45
IndustryMedical - Devices
Share Statistics
EPS (TTM)-1.49
Shares Outstanding29,430,390
10 Day Avg. Volume576,705
30 Day Avg. Volume510,665
Financial Highlights & Ratios
PEG Ratio0.99
Price to Book (P/B)91.68
Price to Sales (P/S)10.23
P/FCF Ratio-37.92
Enterprise Value/Market Cap1.10
Enterprise Value/Revenue9.28
Enterprise Value/Gross Profit13.25
Enterprise Value/Ebitda-104.73
Forecast
1Y Price Target
$89.57Price Target Upside33.53% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering7
EPS Forecast (FY)-1.15
Revenue Forecast (FY)$267.19M
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...
How the Company Makes Money
Establishment Labs makes money primarily by selling breast implants and related surgical/aesthetic products to customers in the healthcare channel (e.g., hospitals, clinics, and surgeons) across the geographies where it is approved to market and d...
Establishment Labs Holdings Earnings Call Summary
Earnings Call Date:May 06, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Aug 06, 2026
Earnings Call Sentiment Positive
The call communicated strong operational and commercial momentum led by a rapid U.S. launch, 45% YoY revenue growth in Q1, improving gross margin (70.7%) and a return to positive adjusted EBITDA. Key product innovations (minimally invasive platform) are driving adoption, surgeon and patient demand, and management raised full-year revenue guidance. Offsetting factors include elevated operating expenses, near-term cash usage and increased debt with PIK mechanics, plus some supply and geopolitical uncertainties. Overall, the positives around revenue acceleration, margin expansion, product differentiation and pathway to cash-flow positivity materially outweigh the risks discussed.Positive Updates
Strong Top-Line Growth
Q1 2026 revenue of $59.9M, up 44.7% YoY (management rounded to 45%), with full-year guidance raised to $266.5M–$268.5M (≈26%–27% growth vs. 2025).
Negative Updates
Cash Decline and Near-Term Cash Usage
Cash decreased $7.5M in Q1 to $68.1M; management expects higher cash usage in Q2 driven by a final $4.7M Benelux acquisition payment, short-term incentive payouts and continued U.S. commercial investments.
Read all updates
Q1-2026 Updates
Positive
Negative
Strong Top-Line Growth
Q1 2026 revenue of $59.9M, up 44.7% YoY (management rounded to 45%), with full-year guidance raised to $266.5M–$268.5M (≈26%–27% growth vs. 2025).
Read all positive updates
Company Guidance
Management raised full‑year revenue guidance to $266.5–$268.5 million (up from $264–$266M), implying ~26–27% growth versus 2025, after a strong Q1: $59.9M revenue (+44.7% YoY), U.S. revenue $19.6M (32.7% of Q1, +216% YoY), minimally invasive (MIS) revenue $9.1M in Q1 and MIS now expected to exceed $35M in 2026 (prior MIS guide $30M), and adjusted EBITDA of $1.2M in Q1 (third consecutive quarter of positive adjusted EBITDA). Full‑year gross margin is guided to 71.2–72.2% (Q1 GM 70.7%, +350 bps YoY), operating expenses $195–$200M, and management expects adjusted EBITDA to be positive each quarter and to be cash‑flow positive in H2 2026; cash was $68.1M at quarter end (down $7.5M), Q2 cash usage will be higher (including a $4.7M Benelux payment) but Q2 EBITDA is expected to be roughly double Q1, U.S. revenue is expected to exceed 30% of total for the year (vs ~22% in 2025) while OUS growth is expected in the single digits. They also refinanced debt (availability up to $265M from $225M, 8.75% rate with PIK optionality) and highlighted PIK interest benefit of more than $5M per quarter supporting near‑term cash flow.Establishment Labs Holdings Financial Statement Overview
Summary
Income Statement
43
Neutral
Balance Sheet
52
Neutral
Cash Flow
28
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 229.58M | 211.08M | 166.03M | 165.15M | 161.70M | 126.68M |
| Gross Profit | 160.84M | 146.31M | 109.53M | 106.98M | 106.59M | 85.40M |
| EBITDA | -20.35M | -32.77M | -56.22M | -58.31M | -56.90M | -26.54M |
| Net Income | -43.74M | -51.06M | -84.60M | -78.50M | -75.21M | -41.14M |
Balance Sheet | ||||||
| Total Assets | 351.04M | 357.17M | 346.83M | 268.64M | 211.06M | 139.53M |
| Cash, Cash Equivalents and Short-Term Investments | 68.10M | 75.57M | 90.35M | 40.03M | 66.36M | 53.41M |
| Total Debt | 263.96M | 264.47M | 225.29M | 192.22M | 179.35M | 54.21M |
| Total Liabilities | 336.25M | 333.62M | 293.74M | 250.25M | 219.25M | 88.79M |
| Stockholders Equity | 14.78M | 23.55M | 53.09M | 18.39M | -8.19M | 50.74M |
Cash Flow | ||||||
| Free Cash Flow | -42.12M | -56.94M | -74.08M | -113.06M | -86.43M | -34.26M |
| Operating Cash Flow | -34.81M | -50.89M | -58.52M | -88.51M | -52.17M | -27.53M |
| Investing Cash Flow | -7.70M | -7.03M | -15.61M | -24.55M | -34.79M | -7.16M |
| Financing Cash Flow | 40.08M | 40.43M | 125.89M | 86.23M | 100.25M | 4.05M |
Establishment Labs Holdings Technical Analysis
Positive
67.08
Price Trends
67.05
Positive
68.50
Negative
56.75
Positive
Market Momentum
-0.08
Negative
57.79
Neutral
80.77
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 67.08 is above the 20-day moving average (MA) of 60.74, above the 50-day MA of 67.05, and above the 200-day MA of 56.75, indicating a bullish trend. The MACD of -0.08 indicates Negative momentum. The RSI at 57.79 is Neutral, neither overbought nor oversold. The STOCH value of 80.77 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 66 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 |
|---|---|---|---|---|---|---|---|
76 Outperform | $883.80M | 48.32 | 16.27% | ― | 1.52% | ― | |
73 Outperform | $880.69M | 18.75 | 13.28% | ― | -4.53% | -41.70% | |
58 Neutral | $1.94B | -31.42 | -225.86% | ― | 34.86% | 52.13% | |
55 Neutral | $1.07B | 19.55 | 5.40% | 2.02% | 4.78% | -53.80% | |
55 Neutral | $1.11B | 310.60 | 2.66% | ― | 17.59% | ― | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
46 Neutral | $772.51M | -68.39 | -30.23% | ― | 119.23% | 40.14% |
* Healthcare Sector Average
ESTA
Establishment Labs Holdings
65.76
28.94
78.60%
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Establishment Labs Holdings Corporate Events
Business Operations and StrategyPrivate Placements and Financing
Establishment Labs Amends Credit Agreement, Secures New Financing
Neutral
Apr 30, 2026
On April 30, 2026, Establishment Labs Holdings Inc. amended and restated its existing credit agreement, securing up to $300 million in term loans from lenders led by Oaktree Fund Administration. The new facility, split into a $265 million tranche ...
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.