Establishment Labs Holdings (ESTA) AI Stock Analysis

• Market Cap: $1.10B
• Dividend Yield: N/A
• Average Volume (3M): 389.27K
• Price to Earnings (P/E): ―
• Beta (1Y): 1.38
• Revenue Growth: 9.27%
• EPS Growth: 1.51%
• Country: US
• Employees: 1,034
• Sector: Healthcare
• Sector Strength: 48
• Industry: Medical - Devices
• EPS (TTM): -0.70
• Shares Outstanding: 28,917,253
• 10 Day Avg. Volume: 404,571
• 30 Day Avg. Volume: 389,266
• PEG Ratio: -0.27
• Price to Book (P/B): -196.17
• Price to Sales (P/S): 0.00
• P/FCF Ratio: -18.58
• Enterprise Value/Market Cap: 1.56
• Enterprise Value/Revenue: 2.68
• Enterprise Value/Gross Profit: 15.21
• Enterprise Value/Ebitda: -7.59
• 1Y Price Target: $53.14
• Price Target Upside: 40.54% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 7

• Rating: 56 Neutral
• Price Target: $38.00 ▲(0.50%Upside)

Establishment Labs Holdings faces significant challenges with profitability and financial stability, which weigh heavily on the overall score. Positive momentum and U.S. market success provide some optimism, but valuation concerns persist due to negative earnings. Corporate events, such as the successful product launch and new CEO appointment, offer potential for strategic growth.

Positive Factors

Earnings

US sales grew 91% sequentially and beat consensus.

Market Demand

The demand for Motiva implants in the U.S. remains strong, with lengthy waitlists and no signs of a slowdown.

Product Innovation

The Motiva Flora expander is the only MRI-compatible system and can remain implanted when patients need to be re-scanned.

Negative Factors

International Business

Analyst is concerned that the US launch may not be enough to offset macro headwinds in the international business.

Revenue Growth

Revenue growth slowed to 11% in 1Q25 from 41% in 4Q24.

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 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 Money

Establishment Labs Holdings makes money primarily through the sale of its silicone gel-filled breast implants, including the flagship Motiva Implants. The company's revenue model is based on the direct sale of these products to plastic surgeons and healthcare providers around the world. Establishment Labs has a significant presence in international markets, with distribution networks and partnerships that facilitate the global reach of its products. The company also invests in research and development to continually innovate and expand its product offerings, which can drive additional revenue streams. Key factors contributing to its earnings include market demand for aesthetic and reconstructive surgeries, regulatory approvals in various countries, and the establishment of strategic partnerships for distribution and marketing.

Establishment Labs Holdings Financial Statement Overview

Summary

Establishment Labs Holdings shows strong revenue growth but struggles with profitability and financial stability. The gross profit margin is high, but net losses, negative free cash flow, and a low equity base remain concerns.

Income Statement

The company has shown a consistent increase in revenue over the years, with a revenue growth rate of 2.53% from 2024 to TTM 2025. However, profitability remains a challenge, as indicated by the negative EBIT and net profit margins. The gross profit margin for TTM 2025 is relatively healthy at 66.34%, but the net income is deeply negative, leading to a net profit margin of -52.34%. The EBIT and EBITDA margins are also negative, indicating operational inefficiencies.

Balance Sheet

The balance sheet shows a high level of liabilities relative to equity, with a debt-to-equity ratio of 0.10 in TTM 2025, which is significantly lower than previous years, indicating reduced leverage. However, the company has a low return on equity (ROE) due to its negative net income. The equity ratio is low at 11.56% in TTM 2025, suggesting limited equity financing. The financial stability is a concern given the company's high liabilities and minimal equity.

Cash Flow

Cash flow analysis indicates negative free cash flow, though it has shown some growth with a free cash flow growth rate of 7.57% from 2024 to TTM 2025. The operating cash flow to net income ratio is less meaningful due to negative values for both metrics. The company relies heavily on financing activities to fund its operations, which could pose risks if financing becomes constrained.

Breakdown
TTM	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020
Income Statement		Total Revenue
170.24M	166.03M	165.15M	161.70M	126.68M	84.68M
	Gross Profit
112.95M	109.53M	106.98M	106.59M	85.40M	52.50M
	EBIT
-58.10M	-49.99M	-65.03M	-39.66M	-25.14M	-27.92M
	EBITDA
-63.20M	-56.22M	-58.31M	-56.90M	-26.54M	-24.93M
	Net Income Common Stockholders
-89.10M	-84.60M	-78.50M	-75.21M	-41.14M	-38.12M
Balance Sheet		Cash, Cash Equivalents and Short-Term Investments
69.18M	90.35M	40.03M	66.36M	53.41M	84.52M
	Total Assets
333.36M	346.83M	268.64M	211.06M	139.53M	156.39M
	Total Debt
3.80M	225.29M	192.22M	178.66M	53.81M	51.76M
	Net Debt
-65.38M	134.95M	152.19M	112.31M	391.00K	-32.77M
	Total Liabilities
294.81M	293.74M	250.25M	219.25M	88.79M	81.43M
	Stockholders Equity
38.55M	53.09M	18.39M	-8.19M	50.74M	74.96M
Cash Flow		Free Cash Flow
-69.53M	-64.63M	-113.06M	-86.43M	-34.26M	-16.42M
	Operating Cash Flow
-68.12M	-58.52M	-88.51M	-52.17M	-27.53M	-12.51M
	Investing Cash Flow
-10.33M	-15.61M	-24.55M	-34.79M	-7.16M	-5.56M
	Financing Cash Flow
76.23M	125.89M	86.23M	100.25M	4.05M	64.67M

Establishment Labs Holdings Technical Analysis

• Technical Analysis Sentiment: Positive
• Last Price: 37.81
• 50DMA: Positive
• 100DMA: Positive
• 200DMA: Negative
• MACD: Positive
• RSI: Neutral
• 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 37.81 is above the 20-day moving average (MA) of 37.09, above the 50-day MA of 34.43, and below the 200-day MA of 39.02, indicating a neutral trend. The MACD of 0.84 indicates Positive momentum. The RSI at 55.04 is Neutral, neither overbought nor oversold. The STOCH value of 45.30 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
PCRX	59 Neutral	$1.12B	―	-12.27%	―	3.08%	-247.82%
INVA	57 Neutral	$1.35B	89.44	-8.84%	―	17.90%	-133.73%
ESTA	56 Neutral	$1.10B	―	-186.68%	―	9.27%	1.51%
NEO	55 Neutral	$894.43M	―	-8.57%	―	10.10%	8.79%
Sector *	53 Neutral	$5.24B	3.32	-44.36%	6.63%	16.78%	-0.12%
OPK	52 Neutral	$1.02B	―	-3.04%	―	-13.79%	82.82%
KMTS	34 Underperform	$796.16M	―		―	―	―

Establishment Labs Holdings Corporate Events

Establishment Labs Launches Motiva Implants in U.S.

On June 12, 2025, Establishment Labs Holdings Inc. held an analyst and investor event in New York City, where they announced the successful launch of Motiva implants in the United States, with over 1,000 surgeons now offering the product. The company projects $9.5 million to $10 million in sales for the second quarter of fiscal 2025 and plans to seek FDA approval for Motiva Implants for reconstruction use by the fourth quarter of 2025. Additionally, the launch of Preservé in the U.S. is anticipated in the first half of 2026. These developments are expected to strengthen the company’s position in the breast aesthetics and reconstruction market, with a focus on achieving significant growth and efficiency in operations.

The most recent analyst rating on (ESTA) stock is a Buy with a $48.00 price target. To see the full list of analyst forecasts on Establishment Labs Holdings stock, see the ESTA Stock Forecast page.

Establishment Labs Holds Annual Shareholder Meeting

On May 23, 2025, Establishment Labs Holdings held its Annual Meeting of Shareholders, where three key proposals were voted on. The election of directors saw Juan Jose Chacón Quirós, Ann Custin, Nicholas Lewin, Edward Schutter, and Bryan Slotkin elected to serve until the 2026 meeting. Additionally, the compensation of the named executive officers was approved on an advisory basis, and the appointment of CBIZ, CPAs P.C. as the independent registered public accounting firm for the fiscal year ending December 31, 2025, was ratified.

The most recent analyst rating on (ESTA) stock is a Buy with a $48.00 price target. To see the full list of analyst forecasts on Establishment Labs Holdings stock, see the ESTA Stock Forecast page.

Establishment Labs Appoints Filippo Caldini as CEO

On May 6, 2025, Establishment Labs Holdings Inc. appointed Filippo ‘Peter’ Caldini as the Chief Executive Officer, effective May 7, 2025, following an extensive search process. Caldini, who has been serving as the interim CEO since March 2025, will also join the Board of Directors as a Class II director. This leadership change is expected to drive the company’s strategic goals, including achieving EBITDA positive status in 2025 and cash flow positive in 2026, as the company continues to innovate and expand its market presence, particularly with its upcoming launch in the United States.