Costa Rica — May 6, 2026 — Leads & Copy — Establishment Labs Holdings Inc. (NASDAQ: ESTA) reported its first-quarter financial results, with revenue reaching $59.9 million, a 44.7% increase from Q1 2025. The company has raised its revenue guidance for the year to between $266.5 million and $268.5 million.
Motiva sales in the United States totaled $19.6 million, marking a 13.3% rise from Q4 2025. Revenue from minimally invasive products reached $9.1 million for the quarter.
The gross margin improved to 70.7% compared to 67.2% in the same period last year. The loss from operations was $6.5 million, a significant decrease from the $16.9 million loss in the year-ago period. Adjusted EBITDA showed an income of $1.2 million, compared to a loss of $12.1 million in the previous year. Cash use was reduced to $7.5 million, compared to $21.2 million in the same period last year. The company’s cash balance as of March 31, 2026, was $68.1 million.
CEO Peter Caldini stated that the company’s momentum is accelerating in both the U.S. and international markets. He noted the strong start of the U.S. launch of their minimally invasive platform, which is expected to contribute at least 13% of the 2026 revenue, an increase from previous estimates. Caldini also highlighted the third consecutive quarter of positive adjusted EBITDA.
CFO Sandra Harris mentioned that the first-quarter performance gave the company confidence to raise its annual guidance. She also noted that the recent refinancing with Oaktree extends their debt maturity and enhances financial flexibility. The company anticipates being free cash flow positive in the second half of the year and is focused on increasing earnings per share each year.
Total revenue for the first 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 was $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.
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.
The company has raised its revenue guidance to $266.5 million – $268.5 million and expects gross margins of 71.2% – 72.2% and operating expenses of $195 million – $200 million. Adjusted EBITDA is expected to be positive every quarter, with free cash flow positive in the second half of the year.
Establishment Labs is a global medical device company focused on improving women’s health and wellness in breast aesthetics and reconstruction. Its portfolio includes solutions for breast health, aesthetics, and reconstruction, with five million Motiva® devices delivered since 2010. The company’s minimally invasive platform includes Mia Femtech®, and Preservé™. 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. Establishment Labs manufactures at two facilities in Costa Rica compliant with all applicable regulatory standards under ISO13485:2024 and FDA 21 CFR 820.
Source: Establishment Labs
