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 fourth quarter and full year ended December 31, 2025 and provided 2026 guidance.

Fourth Quarter Highlights and Outlook

Fourth quarter revenue of $64.6 million, an increase of 45.2% from the year-ago period.
2025 revenue of $211.1 million, an increase of 27.2% over 2024.
Motiva U.S. revenue in the fourth quarter of $17.3 million, and full year U.S. revenue of $45.6 million.
Fourth quarter net loss from operations of $3.9 million, a 79% reduction compared to a net loss of $18.7 million in the year-ago period.
Fourth quarter adjusted EBITDA of positive $5.5 million, an $18.6 million increase compared to a loss of $13.1 million in the year-ago period.
Cash balance of $75.6 million as of December 31, 2025, an increase of $4.9 million compared to Q3 2025.
2026 revenue guidance of $264 million to $266 million, an increase of 25.1% to 26.0% over 2025.
2027 revenue growth projected to be at least 25%.

"Our growth and momentum from 2025 has continued into 2026 with strong demand from both surgeons and patients," said Peter Caldini, Chief Executive Officer. "Preservé has been exceptionally well received in markets around the globe, creating market expansion in both dollar and procedure volumes. We have pioneered a new category of tissue‑preserving and minimally invasive options which offer patients the benefits of minimal anesthesia and faster recovery. This is broadly resonating with a whole new group of consumers and driving meaningful growth for plastic surgery and Establishment Labs.

"We delivered these results while maintaining strong financial discipline and achieving positive adjusted EBITDA over the second half of the year. We are taking share while growing markets and expect topline growth to exceed 25% in both 2026 and 2027. Our operating model is now displaying the significant leverage we have previously shared. We are positioned for our first quarter of positive cash flow in 2026, and full year of positive cash flow in 2027."

Fourth Quarter 2025 Financial Results

Total revenue for the quarter ended December 31, 2025 was $64.6 million compared to $44.5 million for the same period in 2024.

Gross profit for the fourth quarter was $45.5 million, or 70.5% of revenue, compared to $30.5 million, or 68.5% of revenue, for the same period in 2024.

Total operating expenses for the fourth quarter were $49.5 million, an increase of $0.3 million compared to $49.2 million in the fourth quarter of 2024.

SG&A expenses remained stable at $44.0 million in the fourth quarter of 2025 and 2024.

R&D expenses increased approximately $0.3 million to $5.4 million in the fourth quarter compared to $5.1 million for the same quarter a year ago. The increase was due to personnel cost and the timing of regulatory and compliance costs.

Net loss from operations for the fourth quarter was $3.9 million compared to a net loss of $18.7 million in the year-ago period.

Adjusted EBITDA for the fourth quarter was a positive $5.5 million compared to a loss of $13.1 million in the year-ago period.

The Company's cash balance on December 31, 2025 was $75.6 million. Cash decreased $14.8 million from December 31, 2024 and increased $4.9 million from the prior quarter, primarily as a result of operating activities and investments offset by expense reduction initiatives and additional borrowings.

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. The conference call can be accessed by dialing (877) 407-8037 (U.S. and Canada) or (201) 689-8037 (international) and using conference ID number 13758679. In addition, the live and archived webcast will be available on the Investor Relations section of the Company's 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 over four 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 breast augmentation, revision augmentation and 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 Zenº™, currently part of an IRB approved pivotal study to measure core breast temperature. These solutions are supported by over 200 patents 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 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, changes in contingent considerations payable for business acquisitions, and foreign currency gains and losses. 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 reasonable 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 quarterly report on Form 10-Q filed on November 7, 2025 and will be discussed in the company's annual report on Form 10-K that will be 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)


	Three Months Ended December 31,						Year Ended December 31,
		2025			2024			2025			2024

Revenue	$	64,617		$	44,514		$	211,076		$	166,025
Cost of revenue		19,085			14,022			64,768			56,500
Gross profit		45,532			30,492			146,308			109,525
Operating expenses:
Sales, general and administrative		44,028			44,018			165,069			139,806
Research and development		5,434			5,144			20,247			19,706
Total operating expenses		49,462			49,162			185,316			159,512
Loss from operations		(3,930	)		(18,670	)		(39,008	)		(49,987	)
Interest income		34			199			423			1,477
Interest expense		(7,244	)		(5,949	)		(25,256	)		(20,829	)
Other income (expense), net		(775	)		(11,519	)		5,819			(15,289	)
Loss before income taxes		(11,915	)		(35,939	)		(58,022	)		(84,628	)
Benefit for income taxes		9,300			1,408			6,958			32
Net loss	$	(2,615	)	$	(34,531	)	$	(51,064	)	$	(84,596	)

Basic and diluted net loss per share	$	(0.09	)	$	(1.19	)	$	(1.72	)	$	(3.00	)
Weighted average outstanding shares used for basic and diluted net loss per share		29,795,770			28,942,937			29,620,022			28,161,761

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


	December 31,
		2025		2024

Assets
Current assets:
Cash	$	75,572	$	90,347
Accounts receivable, net of allowance for doubtful accounts of $6,835 and $3,088 at December 31, 2025 and 2024, respectively		77,497		65,002
Inventory, net		85,611		78,766
Prepaid expenses and other current assets		11,260		8,922
Total current assets		249,940		243,037
Long-term assets:
Property and equipment, net of accumulated depreciation		75,615		78,028
Goodwill		1,209		1,209
Intangible assets, net of accumulated amortization		9,942		11,683
Right-of-use operating lease assets, net		4,339		5,561
Other non-current assets		16,122		7,313
Total assets	$	357,167	$	346,831
Liabilities and shareholders' equity
Current liabilities:
Accounts payable	$	43,109	$	44,760
Accrued liabilities		18,856		16,536
Other liabilities, short-term		20,177		6,982
Total current liabilities		82,142		68,278
Long-term liabilities:
Note payable, Oaktree, net of debt discount and issuance costs		247,522		219,577
Operating lease liabilities, non-current		2,820		4,203
Other liabilities, long-term		1,136		1,678
Total liabilities		333,620		293,736
Shareholders' equity:
Total shareholders' equity		23,547		53,095
Total liabilities and shareholders' equity	$	357,167	$	346,831

Reconciliation of EBITDA and Adjusted EBITDA

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


	Three Months Ended December 31,						Year Ended December 31,
		2025			2024			2025			2024
	(in thousands)
Net loss	$	(2,615	)	$	(34,531	)	$	(51,064	)	$	(84,596	)
Interest expense		(7,244	)		(5,949	)		(25,256	)		(20,829	)
Interest income		34			199			423			1,477
Benefit for income taxes		9,300			1,408			6,958			32
Depreciation and amortization		(2,485	)		(2,154	)		(9,563	)		(6,834	)
EBITDA		(2,220	)		(28,035	)		(23,626	)		(58,442	)
Stock compensation expense		(2,902	)		(3,546	)		(11,415	)		(14,404	)
Compensation paid in stock in lieu of cash		(97	)		(110	)		(403	)		(964	)
Foreign currency gains (losses)		(989	)		(5,240	)		6,421			(8,819	)
Contract termination costs in non-operating expense		—			(6,004	)		(543	)		(6,004	)
Change in contingent consideration payable for business acquisitions		(3,749	)		—			(4,365	)		—
Adjusted EBITDA	$	5,517		$	(13,135	)	$	(13,321	)	$	(28,251	)

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Investor/Media Contact:

Raj Denhoy

415 828-1044

rdenhoy@establishmentlabs.com

Establishment Labs Reports Fourth Quarter and Full Year 2025 Financial Results and Provides 2026 Guidance