One-glance verdict
Not enough data
Fair value unavailable
Not enough cash-flow history to value this one with our method.
Fundamentals snapshot
Establishment Labs Holdings Inc.
ESTA · NCM · Healthcare · Medical Devices
Current price
$65.97
52-week range
$38.35 - $97.59
Market cap
$1.97B
Balance sheet
Distressed
-1.54x Concerning
Net debt $192.52M. Interest coverage shows how many times profit covers the interest bill.
What stands out
1 Reward
2 Risks
1 rewards · 2 risks
- Reward Revenue grew 16.5% last year.
- Risk Return on equity was -175.3% last year — the company lost money on shareholders' equity.
- Risk Net debt grew 67.2% over 3 years.
What this company does
Establishment Labs Holdings Inc.
Establishment Labs is a medical technology company that makes and sells silicone breast implants for cosmetic and reconstructive surgeries. The company earns its money by selling these implants, under the brand name Motiva, to doctors and hospitals in the Americas, Europe, and Asia. This focus on a specific medical device means its success is closely tied to the global demand for breast procedures and its ability to get its products to surgeons.
How the company got here
Founded in 2004, Establishment Labs started with a focus on improving the safety and outcomes of breast aesthetics and reconstruction for women. The company spent years developing its main product, Motiva Implants, and began selling them internationally in 2010. A major turning point was receiving approval from the U.S. Food and Drug Administration (FDA), a government agency that ensures the safety of medical devices, for its Motiva implants in 2024, allowing it to enter one of the world's largest markets for these products. This, along with the earlier FDA clearance for its Flora tissue expander in 2023, marked a significant step in the company's growth from an international-focused business to a global competitor.
What it actually does
Establishment Labs is a medical technology company that creates products for breast enhancement and reconstruction surgeries. Think of them as a specialized designer and manufacturer of high-tech breast implants and related tools for plastic surgeons. Their products are used for both aesthetic reasons, like breast augmentation, and for reconstructive purposes, such as after a mastectomy due to breast cancer. The company sells these products directly to doctors, hospitals, and clinics, as well as through other distributors in over 90 countries.
Breast Aesthetics and Reconstruction
This is the company's core business and generates the majority of its revenue. It revolves around their line of silicone gel-filled breast implants, sold under the brand name Motiva Implants. Surgeons and their patients pay for these implants for both cosmetic procedures to increase breast size and for rebuilding breasts after surgery. The company has different types of implants, like the Ergonomix model, which is designed to change shape with the body's movement to look and feel more natural. This segment has seen significant growth with the company's recent entry into the U.S. market, which is now a substantial and fast-growing portion of its sales.
Surgical Technologies and Tools
This part of the business provides devices and systems that support breast reconstruction and enable less invasive surgical techniques. A key product is the Motiva Flora tissue expander, a temporary implant used to stretch the skin and muscle to make space for a permanent implant after a mastectomy. Another focus is its minimally invasive platform, which includes systems like Mia Femtech and Preservé, designed to allow for smaller incisions and preserve more of the patient's natural breast tissue during augmentation procedures. While smaller than the implant business, this is a fast-growing area for the company.
What management is betting on now
The company's main focus is on expanding its presence in the United States, which is a huge and profitable market for breast procedures. They are also heavily investing in their minimally invasive platform, betting that more patients will prefer procedures that offer quicker recovery and less scarring. Management is also focused on achieving profitability, aiming to turn the company's growing sales into positive cash flow (the cash left over after all business expenses are paid). Finally, they continue to invest in research and development to create new products and improve existing ones, such as seeking expanded FDA approval for their implants to be used in reconstructive surgeries in the U.S.
Price history
How the share price has moved
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Loading price history…
Earnings history
Last 8 quarters — what happened
Click any quarter to read the call summary and what the numbers say.
FY2024 Q3
$-13.93M
FY2024 Q4
$-21.28M
FY2025 Q1
$-21.48M
FY2025 Q2
$-20.38M
FY2025 Q3
$-13.10M
FY2025 Q4
$-1.99M
FY2026 Q1
$-6.16M
FY2026 Q2
$-20.26M
Revenue
$67.54M
Net income
$-11.75M
Diluted EPS
-0.39
Operating cash flow
$-16.60M
Free cash flow
$-20.26M
Fetching…
Sources
Revenue
$59.88M
Net income
$-13.38M
Diluted EPS
-0.45
Operating cash flow
$-4.31M
Free cash flow
$-6.16M
Fetching…
Sources
Revenue
$64.62M
Net income
$-2.62M
Diluted EPS
-0.07
Operating cash flow
$-162.00K
Free cash flow
$-1.99M
Fetching…
Sources
Revenue
$53.78M
Net income
$-11.15M
Diluted EPS
-0.38
Operating cash flow
$-11.25M
Free cash flow
$-13.10M
Fetching…
Sources
Revenue
$51.30M
Net income
$-16.59M
Diluted EPS
-0.57
Operating cash flow
$-18.75M
Free cash flow
$-20.38M
Fetching…
Sources
Revenue
$41.38M
Net income
$-20.71M
Diluted EPS
-0.70
Operating cash flow
$-20.73M
Free cash flow
$-21.48M
Fetching…
Sources
Revenue
$44.51M
Net income
$-34.53M
Diluted EPS
-1.21
Operating cash flow
$-20.75M
Free cash flow
$-21.28M
Fetching…
Sources
Revenue
$40.23M
Net income
$-16.68M
Diluted EPS
-0.59
Operating cash flow
$-12.46M
Free cash flow
$-13.93M
Fetching…
Sources
Is it cheap or expensive?
Fair value — vs current price $65.97
We couldn't calculate a fair value right now.
Is it drowning in debt?
Distressed
Net debt $192.5M. Interest coverage -1.5x.
Net debt
$192.52M
Interest coverage
-1.54x
Establishment Labs Holdings Inc.'s profit covers its interest bill about 0.0 times over. which is weaker than most peers shown here and 2 peers sit below 1x, which is the danger zone where profit does not fully cover the interest bill.
Distressed
Worse cushion
Baseline
Better cushion
ESTA
BASELINE
Establishment Labs Holdings Inc.
Total debt $263.67M Interest coverage -1.54x This is the baseline the peer rows are being compared against.
Total debt $4.45M Interest coverage 3.42x This peer still has a real interest-payment cushion, while ESTA does not.
Total debt $29.09M Interest coverage 371.93x This peer still has a real interest-payment cushion, while ESTA does not.
Total debt $42.80M Interest coverage -8.50x Neither company has much profit cushion over interest right now.
Total debt $39.63M Interest coverage -1.15x Neither company has much profit cushion over interest right now.
What you should know
The case for and against ESTA
1 Reward
2 Risks
Rewards
-
Revenue grew 16.5% last year.
Risks
-
Return on equity was -175.3% last year — the company lost money on shareholders' equity.
-
Net debt grew 67.2% over 3 years.
The numbers
All the key metrics, grouped by purpose
Tap any ? icon to learn what it means.
Valuation
How expensive the stock looks
P/E (TTM)
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Forward P/E
1,099.50x
P/B
90.99x
P/S
8.00x
EV/EBITDA
-240.27x
PEG ratio
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Profitability
How much profit each dollar creates
Gross margin
70.5%
Operating margin
-6.4%
Net margin
-15.8%
ROE
-175.3%
ROA
-3.4%
Health
Liquidity and balance-sheet strength
Debt / equity
12.20x
Current ratio
3.84x
Quick ratio
2.27x
Total debt
$263.67M
Total cash
$71.16M
Growth
How the business has been compounding
Revenue TTM
$245.82M
Revenue 5Y CAGR
13.6%
EPS TTM
-1.27
EPS 5Y CAGR
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Cash flow
How much cash the business throws off
Operating CF TTM
$-32.32M
Free CF TTM
$-56.94M
FCF margin
-23.2%
Dividend
Shareholder payout
Yield
—
Payout ratio
0.0%
Last ex-div date
—