Establishment Labs Holdings Inc. (NASDAQ:ESTA), a global medical technology company dedicated to improving women's health and wellness, principally in breast aesthetics and reconstruction, today announced financial results for the first quarter ended March 31, 2026.

First Quarter Highlights and Outlook (Unaudited)

Revenue of $59.9 million, up 44.7% from Q1 2025, with guidance raised to $266.5 million to $268.5 million
$19.6 million of Motiva sales in the United States, up 13.3% from Q4 2025
Minimally invasive revenue of $9.1 million for the quarter
Gross margin of 70.7% compared to 67.2% in the year-ago period
Loss from operations was $6.5 million compared to a loss of $16.9 million in the year-ago period
Adjusted EBITDA income of $1.2 million compared to a loss of $12.1 million in the year-ago period
Cash use $7.5 million compared to use of $21.2 million in the year-ago period
Cash balance of $68.1 million as of March 31, 2026

"Our momentum is accelerating across both the United States and OUS (outside of the U.S.) markets," said Peter Caldini, Chief Executive Officer. "The U.S. launch of our minimally invasive platform is off to a strong start and is contributing meaningfully to our growth; we now expect it to make up at least 13% of 2026 revenue, up from previous guidance. At the same time, we've delivered our third consecutive quarter of positive adjusted EBITDA, underscoring the strength of our execution and the operational leverage inherent to this business."

"Our first quarter performance gives us confidence to raise our annual guidance," said Sandra Harris, Chief Financial Officer of Establishment Labs. "Our recent refinancing with Oaktree extends our debt maturity and further enhances our financial flexibility. We expect to be free cash flow positive in the second half of the year and are focused on meaningfully increasing earnings per share every year moving forward."

First Quarter 2026 Financial Results (Unaudited)

Total revenue for the quarter ended March 31, 2026 was $59.9 million, compared to $41.4 million for the same period in 2025, representing a growth of approximately 44.7%, with Motiva U.S. revenue increasing to $19.6 million from $6.2 million in the prior-year period.

Gross profit for the first quarter of $42.3 million, or 70.7% of revenue, increased compared to $27.8 million, or 67.2% of revenue, for the same period in 2025. The improvement in gross profit margin was primarily driven by geographic and channel mix.

Total operating expenses for the first quarter were $48.8 million, $4.0 million higher compared to $44.8 million in the first quarter of 2025. This represents a 8.9% increase supporting a 44.7% growth of revenue, showing our ability to leverage operating expenses as we scale the business.

Net loss for the first quarter was $13.4 million, compared to a net loss of $20.7 million in the year-ago period. Adjusted EBITDA increased by $13.3 million to an income of $1.2 million compared to a loss of $12.1 million in the year-ago period, achieving our third consecutive quarter of positive adjusted EBITDA.

The Company's cash balance on March 31, 2026 was $68.1 million.

Fiscal 2026 Outlook

The Company raises guidance based on the first-quarter 2026 performance, and expects the following results:

Revenue: $266.5 million to $268.5 million, up from our previous range of $264 million to $266 million. Minimally invasive business to exceed $35 million in 2026 up from the previous guidance of $30 million
Gross margin: 71.2% to 72.2%
Operating expenses: $195 million to $200 million
Adjusted EBITDA: Positive every quarter
Free cash flow positive in the second half of the year

Conference Call and Webcast Information

Establishment Labs will host a conference call and webcast today at 8:30 a.m. Eastern Time to discuss its financial results. To participate in the conference call, Dial: 877-407-8037 (US & Canada) or +1 201-689-8037 (international). The call will also be available via live or archived webcast on the "Investor Relations" section of the Establishment Labs website at www.establishmentlabs.com.

About Establishment Labs

Establishment Labs Holdings Inc. is a global medical device company dedicated to improving women's health and wellness in breast aesthetics and reconstruction through the power of science, engineering, and technology. The company offers a portfolio of solutions for breast health, breast aesthetics, and breast reconstruction in over 100 countries. With five million Motiva^® devices delivered to plastic and reconstructive surgeons since 2010, the company's products have created a new standard for safety and patient satisfaction. The company's minimally invasive platform consists of Mia Femtech^®, a unique minimally invasive experience for breast harmonization, and Preservé™, a breast tissue preserving and minimally invasive technology for primary breast augmentation and primary mastopexy augmentation. GEM^® is a next generation minimally invasive system for gluteal ergonomic modeling currently undergoing an IRB approved pivotal study. The Motiva Flora^® tissue expander is used to improve outcomes in breast reconstruction following breast cancer and is the only regulatory-approved expander in the world with an integrated port using radio-frequency technology that is MRI conditional. Zensor™ is an RFID technology platform used to safely identify implantable devices from outside the body, and includes the company's first biosensor Zen™, currently part of an IRB approved pivotal study to measure core breast temperature. These solutions are supported by over 200 patent applications in 20 separate patent families worldwide and over 100 scientific and clinical studies and publications in peer reviewed journals. Establishment Labs manufactures at two facilities in Costa Rica compliant with all applicable regulatory standards under ISO13485:2024 and FDA 21 CFR 820. Please visit our website for additional information at www.establishmentlabs.com.

Non-GAAP Financial Measures

To supplement our financial results presented in accordance with GAAP, this release includes the following measures defined by the Securities and Exchange Commission as non-GAAP financial measures: EBITDA and Adjusted EBITDA. These non-GAAP measures are not based on any comprehensive set of accounting rules or principles and should not be considered a substitute for, or superior to, financial measures calculated in accordance with GAAP, and may be different from non-GAAP measures used by other companies, limiting the usefulness of the measures for comparison with other companies.

EBITDA is defined as net income or loss excluding: (1) interest income and expense; (2) provision for income taxes; and (3) depreciation and amortization. We consider EBITDA useful to an investor in evaluating and facilitating comparisons of our operating performance between periods by removing the impact of our capital structure (primarily interest expense) and asset base (primarily depreciation and amortization) from our operating results.

We also present Adjusted EBITDA which includes additional adjustments for items such as other non-cash charges, gains or losses on extinguishment of debt, share-based compensation, contract termination costs, foreign currency gains and losses and restructuring costs. We believe that Adjusted EBITDA provides useful supplemental information to investors regarding our ongoing operating performance that, when considered with net income and EBITDA, is beneficial to an investor's understanding of our performance.

We believe disclosure of this information is also useful to investors as it provides insight into the earnings that management uses to make strategic decisions. These non-GAAP financial measures should be considered along with, but not as alternatives to, net income or loss as prescribed by GAAP as a measure of our operating performance. EBITDA and Adjusted EBITDA do not represent cash generated from operating activities under GAAP and should not be considered as alternatives to cash flows from operations or any other operating performance measure prescribed by GAAP. These measures are not measures of our liquidity, nor are indicative of funds available to fund our cash needs. These measurements do not reflect cash expenditures for long-term assets and other items that have been and will be incurred. EBITDA and Adjusted EBITDA may include funds that may not be available for management's discretionary use due to functional requirements to conserve funds for capital expenditures, property acquisitions, and other commitments and uncertainties.

Please see "Reconciliation of EBITDA and Adjusted EBITDA" for a reconciliation of these measures to net income (loss), the most directly comparable financial measure. This release also includes information about our expectations regarding Adjusted EBITDA on a forward-looking basis. We have not provided a reconciliation of such forward-looking Adjusted EBITDA information because a reconciliation of such measure to our expected GAAP net income (loss) on a forward-looking basis is not available without unreasonable efforts. The timing or amount of various reconciling items that would impact the forward-looking expectations for this non-GAAP financial measure are uncertain, depend on various factors and cannot be reasonably predicted. Such unavailable information could be material to our results computed in accordance with U.S. GAAP.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the "Exchange Act"). You can find many (but not all) of these statements by looking for words such as "approximates," "believes," "expects," "anticipates," "estimates," "intends," "plans," "intends to," "would," "will," "may" or other similar expressions in this press release. Any statements that refer to projections of our future financial or operating performance, anticipated trends in our business, our goals, strategies, focus and plans, including related product development and commercialization and regulatory approvals, and other characterizations of future events or circumstances, including statements expressing general optimism about future operating results, related to the company's performance are forward-looking statements. We claim the protection of the safe harbor contained in the Private Securities Litigation Reform Act of 1995. We caution investors that any forward-looking statements presented in this report, or that we may make orally or in writing from time to time, are expressions of our beliefs and expectations based on currently available information at the time such statements are made. Such statements are based on assumptions, and the actual outcome will be affected by known and unknown risks, trends, uncertainties, and factors that are beyond our control. Although we believe that our assumptions are reasonable, we cannot guarantee future performance, and some will inevitably prove to be incorrect. As a result, our actual future results and the timing of events may differ from our expectations, and those differences may be material. Factors, among others, that could cause actual results and events to differ materially from those described in any forward-looking statements include risks and uncertainties relating to: our ability to successfully, timely and cost-effectively develop, seek and obtain regulatory clearance for and commercialize our product offerings; the rate of adoption of our products by healthcare providers or other customers; the success of our marketing initiatives; the safe and effective use of our products; our ability to protect our intellectual property; our future expansion plans and capital allocation; our ability to expand upon and/or secure sources of credit or capital; our ability to develop and maintain relationships with qualified suppliers to avoid a significant interruption in our supply chains; our ability to attract and retain key personnel; our ability to scale our operations to meet market demands; the effect on our business of existing and new regulatory requirements; and other economic and competitive factors. These and other factors that could cause or contribute to actual results differing materially from our expectations include, among others, those risks and uncertainties discussed in the company's annual report on Form 10-K filed on February 27, 2026, which risks and uncertainties may be updated in the future in other filings made by the company with the Securities and Exchange Commission. The risks included in those documents are not exhaustive, and additional factors could adversely affect our business and financial performance. We operate in a very competitive and rapidly changing environment. New risk factors emerge from time to time, and it is not possible for us to predict all such risk factors, nor can we assess the impact of all such risk factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements. We are not undertaking any obligation to update any forward-looking statements. Accordingly, investors should use caution in relying on past forward-looking statements, which are based on known results and trends at the time they are made, to anticipate future results or trends.

ESTABLISHMENT LABS HOLDINGS INC. Consolidated Statements of Operations
(In thousands, except share and per share data)
(Unaudited)



	Three Months Ended
	March 31,
		2026			2025
Revenue	$	59,877		$	41,377
Cost of revenue		17,542			13,569
Gross profit		42,335			27,808
Operating expenses:
Sales, general and administrative		43,605			39,699
Research and development		5,241			5,055
Total operating expenses		48,846			44,754
Loss from operations		(6,511	)		(16,946	)
Interest income		26			250
Interest expense		(7,088	)		(5,853	)
Other income, net		479			2,753
Loss before income taxes		(13,094	)		(19,796	)
Provision for income taxes		(288	)		(914	)
Net loss	$	(13,382	)	$	(20,710	)

Basic and diluted net loss per share	$	(0.45	)	$	(0.70	)
Weighted average outstanding shares used for basic and diluted net loss per share		29,947,157			29,475,649

ESTABLISHMENT LABS HOLDINGS INC. Consolidated Balance Sheets
(In thousands)



	March 31,		December 31,
	2026		2025
	(Unaudited)
Assets
Current assets:
Cash and cash equivalents	$	68,101	$	75,572
Accounts receivable, net		77,076		77,497
Inventory, net		86,659		85,611
Prepaid expenses and other current assets		13,991		11,260
Total current assets		245,827		249,940
Long-term assets:
Property and equipment, net		74,654		75,615
Goodwill		1,209		1,209
Intangible assets, net		9,303		9,942
Right-of-use operating lease assets, net		3,930		4,339
Other non-current assets		16,114		16,122
Total assets	$	351,037	$	357,167
Liabilities and Shareholders' Equity
Current liabilities:
Accounts payable	$	41,813	$	43,109
Accrued liabilities		22,211		18,856
Other liabilities, short-term		19,129		20,177
Total current liabilities		83,153		82,142
Long-term liabilities:
Note payable, net		248,592		247,522
Operating lease liabilities, long-term		2,407		2,820
Other liabilities, long-term		2,102		1,136
Total liabilities		336,254		333,620
Shareholders' equity:
Total shareholders' equity		14,783		23,547
Total liabilities and shareholders' equity	$	351,037	$	357,167

ESTABLISHMENT LABS HOLDINGS INC. Reconciliation of EBITDA and Adjusted EBITDA
(In thousands)
(Unaudited)

The following is a reconciliation of net loss to EBITDA and Adjusted EBITDA:


	Three Months Ended
	March 31,
	2026			2025

Net loss	$	(13,382	)	$	(20,710	)
Interest expense		(7,088	)		(5,853	)
Interest income		26			250
Provision for income taxes		(288	)		(914	)
Depreciation and amortization		(2,478	)		(2,335	)
EBITDA		(3,554	)		(11,858	)
Stock compensation expense & compensation paid in stock		(3,100	)		(2,544	)
Foreign currency gain (loss)		(285	)		2,784
Restructuring charges		(1,373	)		—
Adjusted EBITDA	$	1,204		$	(12,098	)

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Investor/Media Contact:

Malavika William

mwilliam@establishmentlabs.com

Establishment Labs Reports First Quarter 2026 Financial Results