# Establishment Labs Holdings (ESTA.US)

Canonical: https://gigainvestors.com/s/ESTA

Analysis as of: 2026-10-16T07:28:21.549Z. Financial observations: FY2015–FY2026.

Listing currency: USD. Reporting currency: USD.

## Verdict

Not a wonderful business

Quality tests for Buy: not passed (profit record: fail; earnings resilience is evidence only). Published buy qualification: no.

Share price: $61.36 per share; close as of 2026-10-15.

## Checklist

### understandable: fail

- 1 revenue decline in the last 10 years (informational)

- more than 2 net loss years

- negative average operating margin

- operating margin variation exceeds 0.35

- Financial history: 10 years

- Years with declining revenue: 1

- Years with a net loss: 10

- Operating margin variation: 0.43×

Chart: Operating margin; fiscal year observations.

- FY2017: -0.58×

- FY2018: -0.39×

- FY2019: -0.35×

- FY2020: -0.33×

- FY2021: -0.20×

- FY2022: -0.25×

- FY2023: -0.39×

- FY2024: -0.30×

- FY2025: -0.18×

- LTM to Jun 2026: -0.08×

### moat: fail

- ROIC median below threshold

- ROIC worst years below threshold (more than 1 bad year allowed)

- ROIC, median of available years: -40.9%

- ROIC, second-lowest year: -113.9%

- Typical minus recent gross margin: -2.6 pp

- Typical gross margin (annual median): 63.4%

- Recent gross margin (lower of latest and 3-year median): 66.0%

- Years with nonpositive capital: 0

- Capital spending / revenue: 6.6%

- ROIC including acquisitions, ten-year median: -74.6%

Chart: ROIC excluding acquisitions; fiscal year observations.

- FY2016: -113.9%

- FY2017: -203.8%

- FY2018: -42.9%

- FY2019: -49.0%

- FY2020: -51.9%

- FY2021: -38.9%

- FY2022: -30.0%

- FY2023: -30.2%

- FY2024: -21.1%

- FY2025: -14.6%

### economics: fail

- owner earnings cash conversion below threshold

- working capital as a share of revenue rose more than 10pp and ends positive

- Cash conversion uses consolidated totals: No

- Owner earnings, five-year total: -$375M

- Net income, five-year total: -$331M

- Working capital / revenue, annual change: 1.8 pp

- Working capital / revenue, change between three-year averages: 12.7 pp

- Working capital / revenue, final three-year average: 55.9%

Chart: Owner earnings · five years; fiscal year observations.

- FY2021: -$41M

- FY2022: -$97M

- FY2023: -$97M

- FY2024: -$92M

- FY2025: -$47M

### management: fail

- Historical market-dollar context (not the management verdict): 2018 to 2025 (7 years)

- potential debt-funded buybacks (informational)

- buybacks unrelated to price (informational)

- ROIC first 3 years vs last 3 years: -113.9% vs -21.1%

- Per-share earnings: -3.41 to -3.00 (three-year endpoint medians)

- per-share value declined or ends nonpositive

- five-year and ten-year diluted share growth both above threshold

- Management verdict uses per-share economic progress: Yes

- Ordinary dilution, 10-year annual growth: 17.3%

- Ordinary dilution, 5-year annual growth: 4.9%

- Market cap gain: $1.6B

- Cumulative retained earnings: -$407M

- Diluted shares, 10-year annual growth: 17.3%

- Diluted shares, 5-year annual growth: 4.9%

- $1 test, starting fiscal year: FY2018

- $1 test, ending fiscal year: FY2025

- Per-share value change: $0.41

- Per-share value, starting three-year median: -$3.41

- Per-share value, ending three-year median: -$3.00

- Buybacks concentrated in cheaper years (correlation): -0.60

- Average buyback yield: 0.0%

- Buyback history: 5 years

- Debt-funded buybacks: Yes

- Cumulative net income, 10 years: -$485M

- ROIC, first three-year median: -113.9%

- ROIC, last three-year median: -21.1%

Chart: Earnings per share; fiscal year observations.

- FY2016: -$3.69

- FY2017: -$3.41

- FY2018: -$1.22

- FY2019: -$1.86

- FY2020: -$1.63

- FY2021: -$1.72

- FY2022: -$3.08

- FY2023: -$3.07

- FY2024: -$3.00

- FY2025: -$1.72

### accounting: pass

- Sloan accruals: -0.0%

- Receivables to sales index (DSRI): 0.94×

- Restructuring years, last five: 0

- Earnings backed by cash: Yes

- Accounting red flags: 0

- Goodwill and intangibles / equity: 0.47×

Chart: Sloan accruals; fiscal year observations.

- FY2016: -26.7%

- FY2017: -5.1%

- FY2018: 11.0%

- FY2019: -7.0%

- FY2020: -16.4%

- FY2021: -9.8%

- FY2022: -10.9%

- FY2023: 3.7%

- FY2024: -7.5%

- FY2025: -0.0%

## Holders

- [Dan Davidowitz](https://gigainvestors.com/pcm): tracked 13F investor; follow the investor page for holding quarter and amounts.

## Price story

Down 34% since Jul 2026 · sales +16.5%

Story as of 2026-10-16T09:58:42.860Z; price observation 2026-10-15.

### Sales · FY2025–2026

sales +16.5%; source https://www.sec.gov/Archives/edgar/data/1688757/000168875726000022/esta-20251231.htm; observed 2026-02-27.

- FY2017: $35M 

- FY2018: $61M 

- FY2019: $90M 

- FY2020: $85M 

- FY2021: $127M 

- FY2022: $162M 

- FY2023: $165M 

- FY2024: $166M 

- FY2025: $211M 

- FY2026: $246M 

### Gross margin · FY2025

gross margin 69.3%; source https://www.sec.gov/Archives/edgar/data/1688757/000168875726000022/esta-20251231.htm; observed 2026-02-27.

- FY2016: 51.0% 

- FY2017: 51.0% 

- FY2018: 59.0% 

- FY2019: 61.3% 

- FY2020: 62.0% 

- FY2021: 67.4% 

- FY2022: 65.9% 

- FY2023: 64.8% 

- FY2024: 66.0% 

- FY2025: 69.3% 

## Owner memo

Memo as of 2026-10-16T08:06:05.509Z.

### How it makes money

Operates in medical devices; annual sales are USD 211.1 million.

- Source: https://www.sec.gov/Archives/edgar/data/1688757/000168875726000022/esta-20251231.htm (filed 2026-02-27); FY2025: revenue 211076000; grossProfit 146308000; margin = grossProfit / revenue.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-10-15); ESTA.US: Establishment Labs Holdings Inc., a medical technology company, manufactures and markets medical devices for breast aesthetic and reconstructive plastic surgeries in Europe, the Middle East, Africa, Latin America, Asia, and the United States. The company offers silicone gel-filled breast implants under the Motiva Implants brand. It also provides breast tissue expanders. The company sells products to physicians, hospitals, and clinics through distributors and its direct sales force. Establishment Labs Holdings Inc. was incorporated in 2004 and is based in Austin, Texas.

### Why customers stay

Margins ranged from 64.8% to 69.3% during 2023–25; it lost 40.9% on its capital.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-27); FY2023: grossProfit / revenue = 64.8%.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-27); FY2024: grossProfit / revenue = 66%.

- Source: https://www.sec.gov/Archives/edgar/data/1688757/000168875726000022/esta-20251231.htm (filed 2026-02-27); FY2025: grossProfit / revenue = 69.3%.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-27); 10-year return on capital observations [[2016,-1.1391684881602915],[2017,-2.0380286599535244],[2018,-0.42924772313296905],[2019,-0.4899064015713312],[2020,-0.518713895945056],[2021,-0.3889126050091057],[2022,-0.30025511768764857],[2023,-0.3019682692703343],[2024,-0.21136378477035642],[2025,-0.14588781109012322]]; median -0.40908016407103737. ROIC follows the displayed moat series; financial companies use return on tangible equity.

### Where the cash goes

Paid dividends in 5 of 10 years.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-27); Dividend observations: [[2016,0],[2017,36065000],[2018,0],[2019,1717000],[2020,154000],[2021,4227000],[2022,3869000],[2023,0],[2024,0],[2025,0]]. Zero only counted when supported by a complete cash-flow statement.

### Are managers owners

Insiders own 10% of the company.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-10-15); ESTA.US SharesStats.PercentInsiders = 10.042 percentage points; cache date 2026-10-15.

### What the price says

The price is 8.6 times annual sales; cash earnings are negative.

- Source: https://eodhd.com/financial-apis/stock-etfs-fundamental-data-feeds/ (filed 2026-02-27); Closing price 61.36 USD; reporting-to-trading FX 1; FY2025 annual sales per share 7.126125699704072; price multiple 8.610569415376451. FY2025 cash earnings/share -1.5972641748881888. Closing-price date 2026-10-15.

## Monthly share-price history (USD per share)

- 2018-07: $26.02 per share

- 2018-08: $27.75 per share

- 2018-09: $24.10 per share

- 2018-10: $22.82 per share

- 2018-11: $25.88 per share

- 2018-12: $27.42 per share

- 2019-01: $26.51 per share

- 2019-02: $25.56 per share

- 2019-03: $24.04 per share

- 2019-04: $25.13 per share

- 2019-05: $22.85 per share

- 2019-06: $21.99 per share

- 2019-07: $24.96 per share

- 2019-08: $19.88 per share

- 2019-09: $18.91 per share

- 2019-10: $18.55 per share

- 2019-11: $24.14 per share

- 2019-12: $27.66 per share

- 2020-01: $27.28 per share

- 2020-02: $20.23 per share

- 2020-03: $14.45 per share

- 2020-04: $17.48 per share

- 2020-05: $19.68 per share

- 2020-06: $18.68 per share

- 2020-07: $18.00 per share

- 2020-08: $18.27 per share

- 2020-09: $18.53 per share

- 2020-10: $25.03 per share

- 2020-11: $25.94 per share

- 2020-12: $37.64 per share

- 2021-01: $50.61 per share

- 2021-02: $69.03 per share

- 2021-03: $62.53 per share

- 2021-04: $72.64 per share

- 2021-05: $79.80 per share

- 2021-06: $87.34 per share

- 2021-07: $79.29 per share

- 2021-08: $75.00 per share

- 2021-09: $71.58 per share

- 2021-10: $81.54 per share

- 2021-11: $64.54 per share

- 2021-12: $67.59 per share

- 2022-01: $52.34 per share

- 2022-02: $60.43 per share

- 2022-03: $67.39 per share

- 2022-04: $70.76 per share

- 2022-05: $61.70 per share

- 2022-06: $54.38 per share

- 2022-07: $59.29 per share

- 2022-08: $62.18 per share

- 2022-09: $54.61 per share

- 2022-10: $56.39 per share

- 2022-11: $63.76 per share

- 2022-12: $65.65 per share

- 2023-01: $68.04 per share

- 2023-02: $71.66 per share

- 2023-03: $67.74 per share

- 2023-04: $69.69 per share

- 2023-05: $64.52 per share

- 2023-06: $68.61 per share

- 2023-07: $72.01 per share

- 2023-08: $60.37 per share

- 2023-09: $49.07 per share

- 2023-10: $29.28 per share

- 2023-11: $25.65 per share

- 2023-12: $25.89 per share

- 2024-01: $38.50 per share

- 2024-02: $45.68 per share

- 2024-03: $50.90 per share

- 2024-04: $50.01 per share

- 2024-05: $52.23 per share

- 2024-06: $45.44 per share

- 2024-07: $44.44 per share

- 2024-08: $45.82 per share

- 2024-09: $43.27 per share

- 2024-10: $43.09 per share

- 2024-11: $45.89 per share

- 2024-12: $46.07 per share

- 2025-01: $32.05 per share

- 2025-02: $42.87 per share

- 2025-03: $40.81 per share

- 2025-04: $30.35 per share

- 2025-05: $34.42 per share

- 2025-06: $42.71 per share

- 2025-07: $41.96 per share

- 2025-08: $41.27 per share

- 2025-09: $40.99 per share

- 2025-10: $47.95 per share

- 2025-11: $69.29 per share

- 2025-12: $72.88 per share

- 2026-01: $68.15 per share

- 2026-02: $78.70 per share

- 2026-03: $56.78 per share

- 2026-04: $68.63 per share

- 2026-05: $70.69 per share

- 2026-06: $85.81 per share

- 2026-07: $92.54 per share

- 2026-08: $69.33 per share

- 2026-09: $64.17 per share

- 2026-10: $61.36 per share

## Annual estimated value (USD per share)

Historical values use today's bond yield for every fiscal year

Historical values use today's FX rate into trading currency for every fiscal year

Historical values use current restated fundamentals and current commodity classification; they are not point-in-time estimates

## Sources

[Original 10-K filing](https://www.sec.gov/Archives/edgar/data/1688757/000168875726000022/esta-20251231.htm); period 2025-12-31, filed 2026-02-27.

Estimates depend on assumptions and are not guarantees or investment advice. Underlying data remains subject to its source licenses; public reading does not grant bulk redistribution rights.