Establishment Labs Holdings Inc.
- Open
- 91.35
- Day high
- 92.86
- Day low
- 89.58
- Prev close
- 92.30
- Volume
- 336K
- Mkt cap
- $2.7B
- P/E (TTM)
- —
- EPS (TTM)
- —
- P/B
- 184.3
- P/S
- 11.9
- Yield
- —
- Per share
- —
- ▼Insiders net selling -$33.2M over the last 3 months (0 open-market buys, 22 sales)
- 🏛Institutions mixed (13F)
Establishment Labs Holdings Inc. (ESTA) is a Healthcare company listed on NASDAQ. The stock is up 123% over the past year. Over the trailing 3 months, insiders filed 0 open-market buys and 22 sales (SEC Form 4).
Establishment Labs Holdings Inc. (ESTA) financials & analyst ratings
Fundamentals (TTM)
Analyst consensus · 3 analysts
Source: exchange market data + company filings. Figures are trailing-twelve-month or as most recently reported. For informational purposes only — not investment advice.
ESTA earnings date, history & EPS estimates
| Report date | EPS est | EPS actual | Surprise | Revenue | Rev. surprise |
|---|---|---|---|---|---|
| May 6, 2026 | $-0.35 | $-0.40 | -12.7% | $60M | +4.3% |
| Feb 24, 2026 | $-0.21 | $-0.09 | +58.1% | $65M | +1.3% |
| Nov 5, 2025 | $-0.54 | $-0.38 | +29.6% | $54M | -15.7% |
| Aug 7, 2025 | $-0.54 | $-0.57 | -5.6% | $51M | -2.2% |
| May 7, 2025 | $-0.83 | $-0.70 | +15.7% | $41M | +0.6% |
| Feb 26, 2025 | $-0.64 | $-0.98 | -53.1% | $45M | +0.1% |
| Nov 7, 2024 | $-0.61 | $-0.59 | +3.3% | $40M | -10.0% |
| Feb 28, 2024 | $-0.91 | $-0.79 | +13.2% | $32M | +0.3% |
| Feb 27, 2023 | $-0.68 | $-0.55 | +19.1% | $44M | +1.3% |
| Mar 1, 2022 | $-0.33 | $-0.60 | -81.8% | $35M | +1.3% |
| Jul 29, 2021 | $-0.28 | $-0.22 | +21.4% | $32M | +0.0% |
| May 5, 2021 | $-0.34 | $-0.29 | +14.7% | $30M | -12.8% |
ESTA insider trading activity (SEC Form 4)
| Date | Insider | Type | Shares | Price |
|---|---|---|---|---|
| Jul 10, 2026 | Chacon Quiros Juan Josedirector | Grant | 11,315 | — |
| Jul 10, 2026 | LEWIN NICHOLAS SHERIDANdirector | Grant | 19,561 | $66.28 |
| Jul 1, 2026 | Gillin Lesliedirector | Grant | 196 | $85.81 |
| Jul 1, 2026 | Custin Anndirector | Grant | 239 | $85.81 |
| Jul 1, 2026 | LEWIN NICHOLAS SHERIDANdirector | Grant | 291 | $85.81 |
| Jul 1, 2026 | SCHUTTER EDWARD Jdirector | Grant | 216 | $85.81 |
| Jul 1, 2026 | Slotkin Bryandirector | Grant | 189 | $85.81 |
| Jun 29, 2026 | Harris Taylor C.director | Grant | 1,949 | — |
| Jun 29, 2026 | Harris Taylor C.director | Grant | 1,281 | — |
| May 28, 2026 | JW Asset Management, LLCother: See footnote 3 | Sell | 113 | $72.50 |
| May 28, 2026 | JW Asset Management, LLCother: See footnote 3 | Sell | 65,100 | $72.89 |
| May 28, 2026 | JW Asset Management, LLCother: See footnote 3 | Sell | 25,320 | $74.39 |
| May 26, 2026 | Gillin Lesliedirector | Grant | 2,354 | — |
| May 26, 2026 | LEWIN NICHOLAS SHERIDANdirector | Grant | 2,354 | — |
| May 26, 2026 | Custin Anndirector | Grant | 2,354 | — |
Source: ESTA SEC Form 4 filings, latest Jul 10, 2026. For informational purposes only — not investment advice.
See the full ESTA insider & 13F page →Establishment Labs Holdings Inc. company profile
Overview
Establishment Labs Holdings Inc. (NASDAQ:ESTA) is a Costa Rica-based medical technology company founded in 2004 that specializes in manufacturing and marketing medical devices for aesthetic and reconstructive plastic surgery. The company went public in July 2018 and has grown from a regional player to a global manufacturer with operations across Europe, Latin America, Asia-Pacific, and most recently the United States. Under the leadership of founder Juan José Chacón-Quirós, who recently transitioned from CEO to Chief Evangelist, the company has positioned itself as an innovator in the breast implant market with its flagship Motiva Implants brand and emerging Mia Femtech minimally invasive platform.
Business
Establishment Labs operates in the medical device industry, specifically focusing on breast aesthetics and reconstruction. The company's core business revolves around manufacturing and distributing silicone gel-filled breast implants, which are medical devices surgically implanted to enhance breast size or reconstruct breasts following mastectomy. The company's primary product line is Motiva Implants, a premium brand of silicone gel-filled breast implants that incorporates proprietary technologies. These implants feature advanced surface texturing and silicone gel formulations designed to reduce complications like capsular contracture (scar tissue formation around the implant). The Motiva portfolio includes various product variants such as Ergonomix (gravity-sensitive round implants) and Ergonomix2 platform for different patient needs. Beyond traditional implants, Establishment Labs has diversified into several complementary areas. Motiva Flora is a tissue expander used in breast reconstruction procedures, typically for cancer patients who have undergone mastectomy. The device gradually stretches the chest tissue to create space for a permanent implant. The company also distributes the Puregraft line of products for autologous fat transfer procedures, where a patient's own fat is harvested and redistributed for breast enhancement. The company's newest innovation is Mia Femtech, a minimally invasive breast enhancement platform that represents a departure from traditional surgical implants. This technology targets women who desire breast enhancement but prefer less invasive procedures than traditional implant surgery. The Mia platform addresses a potentially large untapped market, as approximately 40% of Mia patients were not previously considering breast augmentation. Revenue breakdown by segment shows traditional implants comprising the vast majority of sales, with Mia Femtech expected to contribute $8-10 million in 2025. Geographically, the company generates revenue across multiple regions: Europe/Middle East/Africa (approximately 38% of sales), Asia-Pacific (35%), Latin America (18%), and North America (9% and growing rapidly following recent FDA approval).
Revenue model
Establishment Labs generates revenue primarily through direct product sales of medical devices to plastic surgeons, hospitals, and clinics. The company employs a hybrid distribution model, selling through both exclusive regional distributors and its own direct sales force depending on the market. In more mature markets like Europe and established relationships, the company often uses distributors, while in strategic growth markets like the United States, it maintains direct sales control. The company's revenue model is based on unit sales of implants and related devices, with pricing varying significantly by geography. US pricing commands premium rates compared to international markets, with management expecting 200-300 basis points of gross margin improvement as US sales scale. The typical customer is a plastic surgeon performing either aesthetic enhancement procedures (paid out-of-pocket by patients) or reconstructive procedures (often covered by insurance). For the Mia Femtech platform, Establishment Labs uses a different business model centered on partnerships with specialized clinics. Rather than selling devices directly, the company certifies clinics and surgeons to offer the Mia procedure, likely earning revenue through equipment sales, consumables, and potentially procedure-based fees. This model targets a different customer segment - women seeking less invasive enhancement options. Several factors influence the company's margins and profitability. Positive margin drivers include geographic mix shift toward higher-priced US market, manufacturing scale efficiencies as volumes grow, and premium pricing for innovative products like Motiva's advanced technology. The company's manufacturing operations in Costa Rica provide cost advantages compared to competitors in higher-cost jurisdictions. Margin pressures come from competitive pricing in international markets, regulatory compliance costs, research and development investments for new products, and the significant sales and marketing expenses required to educate surgeons and build market share. The aesthetic surgery market is also sensitive to economic conditions, as procedures are typically elective and paid out-of-pocket. Currency fluctuations affect international sales, and the company faces ongoing pressure to invest in clinical studies and regulatory approvals to maintain competitive positioning.
Competitive moat
Establishment Labs operates in a medical device industry with meaningful regulatory barriers to entry, but faces intense competition from well-established multinational corporations. The company's competitive moat is moderate and primarily built around three key elements: regulatory approvals, technological differentiation, and geographic market access. The regulatory moat provides some protection, as obtaining FDA approval and other international medical device certifications requires substantial time, capital, and clinical data. Establishment Labs has invested heavily in securing these approvals, with recent FDA clearance for Motiva Implants in the US representing a significant milestone. However, this moat is not insurmountable, as demonstrated by the presence of multiple competitors in most markets. The company's technological differentiation centers on its proprietary Motiva implant technology, which includes advanced surface texturing and silicone gel formulations designed to reduce complications. The Mia Femtech platform represents a more substantial innovation, potentially creating a new category in breast aesthetics. However, the sustainability of this technological advantage depends on continued R&D investment and the ability to maintain patent protection. Geographic market access provides another defensive element, particularly in markets where Establishment Labs has established distributor relationships or direct sales presence. The company's manufacturing base in Costa Rica offers cost advantages, though this could be replicated by competitors. The primary competitive threats come from much larger, well-resourced medical device companies like Allergan (now part of AbbVie), Mentor (Johnson & Johnson), and Sientra. These competitors have deeper pockets for R&D, marketing, and regulatory affairs, along with established relationships with plastic surgeons. The breast implant market has also faced periodic safety concerns and regulatory scrutiny, which can rapidly shift market dynamics. Overall, Establishment Labs has built a respectable competitive position but lacks the dominant moat characteristics of truly defensible businesses. Success depends heavily on execution, continued innovation, and the ability to compete effectively against larger, better-funded rivals.
Risks & safety
Establishment Labs presents a mixed margin of safety profile with reasonable liquidity but ongoing profitability challenges and high valuation metrics. • **Liquidity and Solvency**: Strong current ratio of 3.36x and quick ratio of 2.05x indicate solid short-term liquidity. Cash position of $69.2 million provides runway, though the company is burning approximately $20-22 million per quarter in free cash flow. • **Debt Position**: Relatively low debt-to-equity ratio of 0.10x suggests manageable leverage, though the company does have credit facilities with Oaktree Capital that could become constraining if performance deteriorates. • **Profitability Metrics**: Company remains unprofitable with negative EBITDA of -$16.9 million in Q1 2025. Management projects first positive EBITDA quarter in 2025 and cash flow breakeven in 2026, but execution risk remains high. • **Valuation Concerns**: Price-to-book ratio of 31.2x appears extremely elevated. EV/EBITDA is negative due to negative EBITDA. With revenue of $166 million in 2024 and current market cap around $1.1 billion, the stock trades at approximately 6.6x revenue. • **Burn Rate**: At current cash burn rates of $20+ million per quarter, the company has roughly 3-4 quarters of runway before needing additional financing, creating potential dilution risk for shareholders. • **Other Considerations**: Recent FDA approval and US market entry provide significant upside optionality, but the company faces execution risk in scaling US operations profitably while managing international market pressures.
Recent development
Establishment Labs has undergone significant strategic evolution over the past few years, transitioning from a regional breast implant manufacturer to a global medical device company with multiple product platforms and geographic expansion initiatives. The most significant recent development has been the successful FDA approval and launch of Motiva Implants in the US market in late 2024. This represents the culmination of years of regulatory work and clinical studies. The US launch has exceeded initial expectations, with over 900 accounts onboarded and strong reorder rates of 84-88%. Daily order volume has grown from 32 orders per day in November 2024 to over 120 orders per day by April 2025, indicating strong market acceptance. The company has simultaneously been developing and launching its Mia Femtech platform, a minimally invasive breast enhancement technology that targets a different market segment than traditional implants. Mia has expanded to 29 cities globally with 78 certified plastic surgeons, and notably, 40% of Mia patients were not previously considering breast augmentation, suggesting the platform is expanding the addressable market rather than just capturing share. Geographically, Establishment Labs has been executing a China market entry strategy, securing distribution partnerships and conducting medical education initiatives. The company expects China to contribute approximately $10 million in revenue and has secured a potential $50 million strategic investment from CBC Group, signaling long-term commitment to the market. The company has also focused heavily on operational efficiency, reducing operating expenses by $12.5 million in 2024 while closing its smallest manufacturing facility. This cost reduction effort aims to position the company for profitability as revenue scales, with management targeting positive EBITDA in the second half of 2025. Leadership transition has been another key development, with founder Juan José Chacón-Quirós stepping down as CEO and transitioning to a "Chief Evangelist" role, while Peter Caldini has been appointed as the new CEO. This change reflects the company's evolution from a founder-led startup to a more mature organization focused on operational execution and profitable growth.
ESTA company profile · for informational purposes only — not investment advice.
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