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Establishment Labs Holdings Inc (ESTA)
NASDAQ:ESTA

Establishment Labs Holdings (ESTA) AI Stock Analysis

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Establishment Labs Holdings

(NASDAQ:ESTA)

Rating:58Neutral
Price Target:
$38.00
▼(-1.40%Downside)
The overall score is influenced primarily by financial performance and technical analysis. Strong revenue growth is offset by profitability challenges and high liabilities. Positive technical indicators support a bullish outlook, while strategic leadership changes are promising but yet to demonstrate impact.
Positive Factors
Financial Performance
ESTA's preliminary 1Q results exceeded Street expectations, with a total revenue of $41.4M.
Product Launch
Management is optimistic about the US Motiva launch, with increased confidence in it being a source of upside in 2025.
Negative Factors
International Business Challenges
An 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 (ESTA) vs. SPDR S&P 500 ETF (SPY)

Establishment Labs Holdings Business Overview & Revenue Model

Company DescriptionEstablishment Labs Holdings (ESTA) is a global medical technology company focused on improving women's health and wellness. The company specializes in the design, development, manufacture, and marketing of advanced silicone gel-filled breast implants. Their core products include the Motiva Implants, which are designed to enhance breast aesthetics and are used in cosmetic and reconstructive surgery. Establishment Labs operates primarily in the aesthetic and reconstructive surgery sectors, with a strong emphasis on innovation and safety.
How the Company Makes MoneyEstablishment 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 Earnings Call Summary

Earnings Call Date:May 07, 2025
(Q1-2025)
|
% Change Since: 15.84%|
Next Earnings Date:Aug 12, 2025
Earnings Call Sentiment Neutral
The earnings call highlighted strong revenue growth, particularly in the U.S. market, along with successful product launches and a positive EBITDA outlook. However, there were challenges in China and Brazil, increased operating expenses, and a significant adjusted EBITDA loss. While there are positive trends, the challenges present a mixed picture.
Q1-2025 Updates
Positive Updates
Strong Revenue Growth
Total revenue for the first quarter was $41.4 million, an increase of 11% from the year-ago period. Excluding the negative impact of foreign exchange, growth would have been 13.5%.
U.S. Market Success
First-quarter sales included $6.2 million from the United States, above the $5.5 million previously guided, reflecting strong adoption that continued into the second quarter.
Motiva Product Launch Success
The launch of Motiva in the U.S. exceeded expectations, with over 900 accounts fully on board and 84% reordering. Daily orders for April exceeded 120, up from 100 in March.
Positive EBITDA Outlook
The company expects its first positive EBITDA quarter in 2025 and cash flow breakeven in 2026.
Gross Margin Improvement
Gross profit for the first quarter was $27.8 million or 67.2% of revenue, a 160 basis point increase compared to the same period in 2024. Expectations are for a 200-300 basis point improvement in gross margins in 2025.
Negative Updates
Challenges in China and Brazil
Minimal sales into China as the distributor sells existing inventory, and a meaningful reduction in revenue from Brazil compared to the first quarter of last year.
Increased Operating Expenses
Operating expenses for the first quarter increased approximately $11.5 million from the year-ago period to $44.8 million, primarily due to the ramp-up of commercial activity in the U.S.
Adjusted EBITDA Loss
Adjusted EBITDA was a loss of $12.1 million, though this was $1 million lower than in the fourth quarter.
Cash Usage
Cash use in the first quarter was $21.2 million, with expectations of sequential improvement but highlighting high initial cash usage.
Company Guidance
During the Establishment Labs First Quarter 2025 Earnings Conference Call, the company provided optimistic guidance for the fiscal year. Establishment Labs reiterated its revenue guidance of $205 million to $210 million, reflecting growth of 23% to 26%, despite global economic uncertainties. The company reported a strong start to the year with first quarter revenue totaling $41.4 million, including $6.2 million from U.S. sales, surpassing previous guidance. Establishment Labs anticipates its first positive EBITDA quarter in the second half of 2025, and cash flow breakeven in 2026, with a gross profit margin expected to improve by 200 to 300 basis points compared to 2024. The launch of Motiva implants in the U.S. has been particularly successful, with over 900 accounts onboard and a high reorder rate of 84%. Establishment Labs remains focused on expanding its market share in the U.S. and globally, with its minimally invasive platforms Mia and Preserve contributing to future growth.

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
55
Neutral
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
45
Neutral
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
50
Neutral
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
TTMDec 2024Dec 2023Dec 2022Dec 2021Dec 2020
Income StatementTotal Revenue
170.24M166.03M165.15M161.70M126.68M84.68M
Gross Profit
112.95M109.53M106.98M106.59M85.40M52.50M
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 SheetCash, Cash Equivalents and Short-Term Investments
69.18M90.35M40.03M66.36M53.41M84.52M
Total Assets
333.36M346.83M268.64M211.06M139.53M156.39M
Total Debt
3.80M225.29M192.22M178.66M53.81M51.76M
Net Debt
-65.38M134.95M152.19M112.31M391.00K-32.77M
Total Liabilities
294.81M293.74M250.25M219.25M88.79M81.43M
Stockholders Equity
38.55M53.09M18.39M-8.19M50.74M74.96M
Cash FlowFree 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
76.23M125.89M86.23M100.25M4.05M64.67M

Establishment Labs Holdings Technical Analysis

Technical Analysis Sentiment
Positive
Last Price38.54
Price Trends
50DMA
34.02
Positive
100DMA
35.24
Positive
200DMA
39.25
Negative
Market Momentum
MACD
1.09
Negative
RSI
61.87
Neutral
STOCH
79.43
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 38.54 is above the 20-day moving average (MA) of 36.74, above the 50-day MA of 34.02, and below the 200-day MA of 39.25, indicating a neutral trend. The MACD of 1.09 indicates Negative momentum. The RSI at 61.87 is Neutral, neither overbought nor oversold. The STOCH value of 79.43 is Neutral, 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 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 (54)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
59
Neutral
$1.15B-12.27%3.08%-247.82%
58
Neutral
$1.12B-186.68%9.27%1.51%
57
Neutral
$1.35B89.44-8.84%17.90%-133.73%
54
Neutral
$5.38B3.40-45.06%3.28%16.75%-0.02%
OPOPK
52
Neutral
$1.09B-3.04%-13.79%82.82%
NENEO
51
Neutral
$1.01B-8.57%10.10%8.79%
34
Underperform
$1.05B
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
ESTA
Establishment Labs Holdings
38.54
-8.89
-18.74%
OPK
Opko Health
1.35
0.04
3.05%
PCRX
Pacira Pharmaceuticals
24.34
-4.34
-15.13%
INVA
Innoviva
21.37
5.47
34.40%
NEO
NeoGenomics
7.83
-6.23
-44.31%
KMTS
Kestra Medical Technologies Ltd.
19.49
-1.50
-7.15%

Establishment Labs Holdings Corporate Events

Executive/Board ChangesShareholder Meetings
Establishment Labs Holds Annual Shareholder Meeting
Neutral
May 27, 2025

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.

Executive/Board ChangesBusiness Operations and Strategy
Establishment Labs Appoints Filippo Caldini as CEO
Positive
May 7, 2025

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.

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.