What were the key takeaways from Establishment Labs's earnings call?

What is Establishment Labs's gross profit margin?

What is the revenue and EPS growth rate for Establishment Labs year over year?

What does Establishment Labs do and what are its main business segments?

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Did Establishment Labs beat or miss consensus estimates last quarter?

What were the key takeaways from Establishment Labs’s earnings call?

- **Record Q3 Performance**: $53.8M revenue (+34% YoY), first positive EBITDA ($1.2M), 70.1% gross margin.
- **U.S. Dominance**: $11.9M sales (16% seq growth), 1,300+ surgeons using Motiva, 20%+ market share.
- **Minimally Invasive Breakthrough**: 300+ Preserve cases, 100+ waitlist, 150+ surgeons trained.
- **2026 Vision**: Cash flow positive, >20% global growth, EBITDA expansion.
- **China Recovery**: Distributor collaboration driving stabilization and growth.

**【CEO Summary Section】**
- Q3 2025 revenue grew 34% YoY to $53.8 million, with U.S. sales reaching $11.9 million (16% sequential growth). 
- Achieved first-ever positive EBITDA of $1.2 million and gross margin of 70.1%, up 620 basis points YoY.
- U.S. breast augmentation market share expected to reach ~20% by year-end, with 1,300+ surgeons using Motiva.
- Launched minimally invasive procedure 'Preserve' in Q3, with 300+ cases performed and 100+ women on waitlist.
- Flora Tissue Expander for breast reconstruction now in use at 10+ U.S. hospitals, on track for FDA approval in early 2026.

**【CFO Financial Commentary】**
- Total revenue: $53.8M (33.7% YoY growth)
- U.S. sales: $11.9M (22.1% of total)
- Europe/Middle East/Africa: $19.1M (35.6% of total)
- Operating expenses: $41.7M (up $2.9M YoY)
- Cash balance: $70.6M (up $16M QoQ)
- 2025 revenue guidance raised to exceed $210M (prev: $208-212M)
- Targeting cash flow positive in 2026 without equity raises.

**【Q&A Highlights】**
- **U.S. Momentum**: Q4 2025 U.S. sales expected to exceed $40M (prev guidance), driven by Preserve adoption and small size implant launches.
- **International Growth**: Direct markets outside U.S. grew 15% YoY, with Europe up 20% and Latin America (esp. Argentina) strong.
- **Preserve Uptake**: 300+ cases performed in Q3, 100+ waitlist, and 150+ surgeons trained to date.
- **China Strategy**: Working with distributor to stabilize and grow, with sell-out progress noted.
- **2026 Outlook**: U.S. market share to ~30%, global revenue growth >20%, EBITDA expansion.


Establishment Labs Holdings Inc. (ESTA) Q3 2025 Earnings Call Transcript

- **U.S. Dominance**: Q2 U.S. sales ($10.3M) exceed guidance, driving 25%-28% 2025 revenue growth to $208-$212M.
- **Profitability Progress**: EBITDA loss narrows to $8.5M (from $12.1M Q1); cash use down 33% to $14.5M.
- **Preservé Launch**: Training program underway, with U.S. cases starting in Q3 and full launch in H1 2026.
- **China Risks**: Market slowdown and distributor challenges; excluded from 2025 guidance.
- **Gross Margin Expansion**: 68.8% gross margin (up 320bps YoY), driven by U.S. sales and cost control.

**【CEO Summary Section】**
- Q2 revenue: $51.3 million (16% YoY growth), with U.S. sales at $10.3 million, exceeding guidance of $9.5-$10 million.
- Raised 2025 revenue guidance to $208-$212 million (25%-28% growth), driven by U.S. sales expected to exceed $40 million.
- U.S. sales momentum continues into Q3 despite seasonal lull; Q2 cash use reduced to $14.5 million (from $21.2 million Q1).
- European direct markets grew 27% YoY, excluding currency and Benelux acquisition; China facing market and operational challenges.
- Launched Preservé training program in Costa Rica, with first U.S. cases expected in Q3 and full launch in H1 2026.
- Flora tissue expander now in 90+ U.S. hospitals; reconstruction FDA submission expected by end of 2025.

**【CFO Financial Commentary】**
- Gross profit: $35.3 million (68.8% of revenue), up 320bps YoY, driven by U.S. sales margins.
- Operating expenses: $49.4 million (11.4 million YoY increase), due to U.S. commercial ramp-up and shipping costs.
- Adjusted EBITDA loss: $8.5 million (improvement from $12.1 million Q1).
- Cash position: $54.6 million (with $25 million available under credit facility).
- 2025 guidance: $208-$212 million revenue, EBITDA positive in Q3/Q4, cash flow breakeven in 2026.

**【Q&A Highlights】**
- **China Challenges**: Distributor scaling issues, market slowdown, and regulatory timing delays; excluded from 2025 guidance.
- **U.S. Growth Trajectory**: Sequential Q3 growth despite seasonality; 1,000+ accounts with 40+ clinics doing >100 procedures YoY.
- **Competitive Response**: Minimal organized reaction; premium pricing sustained with volume discounts for high-volume clinics.
- **Preservé vs. Mia**: Preservé broader appeal, potential for higher revenue; Mia complements with smaller implant focus.
- **Shipping Costs**: Q2 air freight expenses ($11.4 million YoY increase) expected to moderate in H2.


Establishment Labs (ESTA)-7 Aug 25-2025 Q2 Earnings call transcript

- **U.S. Growth Accelerating**: Q1 U.S. sales ($6.2M) exceed guidance, with 900+ Motiva accounts and 120+ daily orders in April.
- **Margin Expansion**: Gross margin up 160bps to 67.2%, driven by U.S. sales at 2x+ price premium.
- **Cash Flow Turning Positive**: Target first EBITDA+ quarter in H2 2025, cash flow breakeven in 2026.
- **Pipeline Momentum**: Preserve launched in Brazil/Europe; Mia on track for $8-10M 2025.
- **Tariff Resilience**: <50bps GM impact; no demand signal disruption.


**【CEO Opening Remarks】**
- Q1 2025 revenue: $41.4 million (+11% YoY). U.S. sales: $6.2 million (vs. $5.5M guidance). OUS stable/improving. 
- 2025 guidance reaffirmed: $205-210M (+23-26% YoY). U.S. revenue to exceed $35M+.
- EBITDA target: first positive quarter in H2 2025; cash flow breakeven in 2026.
- Motiva launch momentum: 900+ U.S. accounts on board (84% reorder rate), 120+ daily orders in April.
- New celebrity partnership with Meghan Trainor generates 4B impressions.

**【CFO Financial Highlights】**
- Gross margin: 67.2% (vs. 65.6% Q1 2024). U.S. sales driving 200-300bps margin expansion.
- Opex: $44.8M (Q1 2025) vs. $33.3M (Q1 2024). U.S. launch and Benelux acquisition drove increase.
- Cash position: $69.2M (March 31). Total liquidity: $94M (includes $25M credit facility).
- Tariffs impact: <50bps on consolidated GM; no demand signal disruption.

**【Q&A Key Takeaways】**
- OUS outlook: mid-single-digit growth. Brazil stabilizing, China inventory normalization.
- Preserve/Mia pipeline: Preserve launched in Brazil/Europe; Mia on track for $8-10M 2025.
- U.S. salesforce: 40 reps (+expansion in key markets). Flora (recon device) gaining traction post-FDA approval.
- Competitive response: limited price discounting; no meaningful impact on Motiva adoption.
- Tariff risk: modeled into guidance; no material impact on 2025 outlook.

**【New Leadership Update】**
- Peter Caldini appointed permanent CEO. Founder JJ Chacon-Quiros remains focused on R&D and surgeon engagement.
- Investor Day scheduled for June 12, 2025 in NYC to provide deeper pipeline visibility.


Establishment Labs Holdings, Inc. (ESTA) Q1 2025 Earnings Call Transcript

- **US Launch Success**: Q4 US sales $3.3M, Q1 on track for $5.5M, with 90/day orders in Feb. Full-year US target $35M, exceeding prior expectations.
- **Global Recovery**: 2025 OUS growth 23-26%, driven by APAC recovery and China partner's $50M investment. Preservé and Mia to drive new market expansion.
- **Financial Turnaround**: EBITDA positive by H2 2025, cash flow breakeven in 2026. Gross margin to expand 200-300bps on US pricing and new products.
- **Pipeline Momentum**: Preservé launched in Brazil with premium pricing; Mia procedures to double to $8-10M in 2025. Reconstruction market expansion with Flora in 35 US cancer centers.

**【CEO Summary Section】**
- **US Launch Momentum**: Q4 US sales reached $3.3 million, with Q1 guidance of $5.5 million and full-year target of $35 million. Order volume increased from 32/day in November to 90/day in February. Over 650 accounts onboarded, 450 have placed orders, and 88% reordered.
- **Global Recovery**: 2025 OUS growth expected at mid-single digits, driven by APAC recovery and EMEA stabilization. China sales to benefit from $50M strategic financing by partner CBC Group.
- **Product Pipeline**: Preservé launched in Brazil with strong demand; Mia expected to double global procedures to $8-10 million in 2025. Reconstruction product Flora gaining traction in 35 US cancer centers.

**【CFO Financial Commentary】**
- **Q4 2024 Results**: Revenue $44.5 million (+41% YoY), gross margin 68.5%, EBITDA loss $13.1 million (vs. $17.4M prior year). Full-year 2024 operating expenses down $12.5 million.
- **2025 Guidance**: Revenue $205-210 million (+23-26%), US sales $35 million, EBITDA positive in H2, cash flow breakeven by 2026. Gross margin to expand 200-300bps due to US pricing and new product launches.
- **Cash Position**: $90.3 million as of Q4, with $25M remaining under credit facility. Q1 2025 cash use elevated due to US commercial ramp, improving sequentially.

**【President's Operational Updates】**
- **Cost Efficiency**: Reduced global headcount by over 30%, closed B15 manufacturing site, and reallocated resources to high-impact initiatives.
- **US Commercial Buildout**: 40 sales reps active, inventory scaled to meet demand. Ergonomix2 platform regulatory submissions underway for Mia Femtech launch.
- **Global Expansion**: China partner CBC Group adding reps and dealers; Brazil Preservé launch saw hundreds of systems ordered at premium pricing.

**【Q&A Highlights】**
- **US Market Penetration**: 90/day order trend in Feb suggests Q1 guidance conservative. 90% of onboarded accounts reordered, with 5 new accounts/day added.
- **Global Growth Drivers**: APAC and EMEA recovery offsetting Latin America weakness. GLP-1 weight loss trend creating new demand for breast augmentation.
- **Regulatory Pathway**: Preservé tools submission in US; reconstruction indication for Motiva implants expected FDA approval in 2026.
- **Cash Flow Trajectory**: Q1 2025 cash use ~$22.6M, improving sequentially as sales leverage fixed costs. EBITDA positive by H2 2025, cash flow breakeven in 2026.

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