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Establishment Labs Holdings Inc. (ESTA) 10-Year Financial Performance & Capital Metrics

ESTA • • Industrial / General
HealthcareMedical DevicesAesthetic & Reconstructive DevicesBreast Implants & Aesthetic Devices
AboutEstablishment Labs Holdings Inc., a medical technology company, manufactures and markets medical devices for aesthetic and reconstructive plastic surgery. The company primarily offers silicone gel-filled breast implants under Motiva Implants brand name. It also provides Motiva Ergonomix and Motiva Ergonomix2 gravity sensitive round soft silicone-gel-filled breast implants; and Motiva Flora Tissue Expander, a breast tissue expander, as well as distributes Puregraft line of products for autologous adipose tissue harvesting and redistribution. The company sells its products through exclusive distributors and direct sales force in Europe, Latin America, the Asia-Pacific, and internationally. Establishment Labs Holdings Inc. was incorporated in 2004 and is headquartered in Alajuela, Costa Rica.Show more
  • Revenue $166M +0.5%
  • EBITDA -$42M +29.5%
  • Net Income -$85M -7.8%
  • EPS (Diluted) -3.00 +2.3%
  • Gross Margin 65.97% +1.8%
  • EBITDA Margin -25.54% +29.9%
  • Operating Margin -30.11% +23.5%
  • Net Margin -50.95% -7.2%
  • ROE -236.67% +84.6%
  • ROIC -20.91% +41.0%
  • Debt/Equity 4.24 -59.4%
  • Interest Coverage -2.40 +43.2%
Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

  • ✓Momentum leader: RS Rating 86 (top 14%)
  • ✓Strong 5Y sales CAGR of 13.1%

✗Weaknesses

  • ✗High debt to equity ratio of 4.2x
  • ✗Negative free cash flow
  • ✗Shares diluted 10.0% in last year
  • ✗Expensive at 35.0x book value

* These insights are generated automatically based on available financial data. Please conduct your own research before making investment decisions.

Price & Volume

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Growth Metrics

Revenue CAGR

10Y-
5Y13.14%
3Y9.43%
TTM24.76%

Profit (Net Income) CAGR

10Y-
5Y-
3Y-
TTM-17.52%

EPS CAGR

10Y-
5Y-
3Y-
TTM-9.65%

ROCE

10Y Avg-52.04%
5Y Avg-25.74%
3Y Avg-27.55%
Latest-20.4%

Peer Comparison

Breast Implants & Aesthetic Devices
Select Columns
Size & Scale
Valuation
Per Share
Growth
Profitability
Quality & Returns
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TTM Growth
Famous Investor Metrics
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Momentum & Returns
Total Return (DRIP)
Technical
Volume & Trading
Shares & Dilution
Sector-Specific
NameMarket CapCurrent PriceP/E RatioRevenue Growth 1YNet MarginROEFCF YieldDebt/Equity
INMDInMode Ltd.888.09M14.056.24-19.76%41.04%22.89%14.86%0.01
RCELAVITA Medical, Inc.105.51M3.46-1.4528.14%-68.87%-230.96%10.22
SSKNSTRATA Skin Sciences, Inc.7.6M1.29-4.960.61%-35.64%-8.4%3.31
ESTAEstablishment Labs Holdings Inc.1.92B65.96-21.990.53%-43.45%-5.07%4.24

Profit & Loss

Dec 2016Dec 2017Dec 2018Dec 2019Dec 2020Dec 2021Dec 2022Dec 2023Dec 2024
Sales/Revenue+19.8M34.68M61.21M89.56M84.68M126.68M161.7M165.15M166.03M
Revenue Growth %-0.75%0.76%0.46%-0.05%0.5%0.28%0.02%0.01%
Cost of Goods Sold+9.71M16.98M25.09M34.7M32.17M41.28M55.1M58.17M56.5M
COGS % of Revenue0.49%0.49%0.41%0.39%0.38%0.33%0.34%0.35%0.34%
Gross Profit+10.1M17.7M36.12M54.86M52.5M85.4M106.59M106.98M109.53M
Gross Margin %0.51%0.51%0.59%0.61%0.62%0.67%0.66%0.65%0.66%
Gross Profit Growth %-0.75%1.04%0.52%-0.04%0.63%0.25%0%0.02%
Operating Expenses+25.93M37.69M59.98M85.8M80.42M110.54M146.25M172M159.51M
OpEx % of Revenue1.31%1.09%0.98%0.96%0.95%0.87%0.9%1.04%0.96%
Selling, General & Admin23.19M30.82M47.3M70.81M66.63M92.23M125.98M145.57M139.81M
SG&A % of Revenue1.17%0.89%0.77%0.79%0.79%0.73%0.78%0.88%0.84%
Research & Development2.74M6.86M12.69M14.99M13.79M18.32M20.27M26.43M19.71M
R&D % of Revenue0.14%0.2%0.21%0.17%0.16%0.14%0.13%0.16%0.12%
Other Operating Expenses000000000
Operating Income+-15.83M-19.98M-23.86M-30.94M-27.92M-25.14M-39.66M-65.03M-49.99M
Operating Margin %-0.8%-0.58%-0.39%-0.35%-0.33%-0.2%-0.25%-0.39%-0.3%
Operating Income Growth %--0.26%-0.19%-0.3%0.1%0.1%-0.58%-0.64%0.23%
EBITDA+-15.24M-18.04M-21.06M-27.64M-24.25M-21.03M-35.49M-60.14M-42.41M
EBITDA Margin %-0.77%-0.52%-0.34%-0.31%-0.29%-0.17%-0.22%-0.36%-0.26%
EBITDA Growth %--0.18%-0.17%-0.31%0.12%0.13%-0.69%-0.69%0.29%
D&A (Non-Cash Add-back)592K1.94M2.8M3.3M3.66M4.11M4.17M4.88M7.58M
EBIT-18.61M-24.37M-12.07M-28.81M-28.64M-30.65M-61.06M-63.19M-63.8M
Net Interest Income+-3.37M-10.4M-8.8M-8.69M-9.36M-9.04M-11.67M-14.37M-19.35M
Interest Income44K19K16K4K15K23K87K1.02M1.48M
Interest Expense3.41M10.42M8.81M8.7M9.37M9.06M11.76M15.39M20.83M
Other Income/Expense-6.19M-14.81M2.98M-6.57M-10.1M-14.57M-33.17M-13.56M-34.64M
Pretax Income+-22.02M-34.79M-20.88M-37.51M-38.02M-39.71M-72.82M-78.58M-84.63M
Pretax Margin %-1.11%-1%-0.34%-0.42%-0.45%-0.31%-0.45%-0.48%-0.51%
Income Tax+134K105K215K640K104K1.43M2.38M-81K-32K
Effective Tax Rate %1.01%1%1.01%1.02%1%1.04%1.03%1%1%
Net Income+-22.16M-34.9M-21.1M-38.15M-38.12M-41.14M-75.21M-78.5M-84.6M
Net Margin %-1.12%-1.01%-0.34%-0.43%-0.45%-0.32%-0.47%-0.48%-0.51%
Net Income Growth %--0.57%0.4%-0.81%0%-0.08%-0.83%-0.04%-0.08%
Net Income (Continuing)-22.16M-34.9M-21.1M-38.15M-38.12M-41.14M-75.21M-78.5M-84.6M
Discontinued Operations000000000
Minority Interest000000000
EPS (Diluted)+-1.20-1.89-1.22-1.86-1.63-1.72-3.08-3.07-3.00
EPS Growth %--0.57%0.35%-0.52%0.12%-0.06%-0.79%0%0.02%
EPS (Basic)-1.20-2.33-1.22-1.86-1.63-1.72-3.08-3.07-3.00
Diluted Shares Outstanding18.49M18.49M17.35M20.54M23.32M23.97M24.46M25.6M28.16M
Basic Shares Outstanding18.49M14.98M17.35M20.54M23.32M23.97M24.46M25.6M28.16M
Dividend Payout Ratio---------

Balance Sheet

Dec 2016Dec 2017Dec 2018Dec 2019Dec 2020Dec 2021Dec 2022Dec 2023Dec 2024
Total Current Assets+12.52M39.38M99.44M95.84M132.3M113.27M149.9M174.9M243.04M
Cash & Short-Term Investments479K10.86M52.64M37.66M84.52M53.41M66.36M40.03M90.35M
Cash Only479K10.86M52.64M37.66M84.52M53.41M66.36M40.03M90.35M
Short-Term Investments000000000
Accounts Receivable6.65M13.11M17.65M22.77M19.13M24.44M35.42M46.92M65M
Days Sales Outstanding122.55137.96105.2492.7882.4570.4179.96103.69142.9
Inventory4.8M13.17M24.84M28.66M23.21M28.41M36.58M79.47M78.77M
Days Inventory Outstanding180.53283.18361.44301.43263.31251.19242.32498.62508.84
Other Current Assets004.3M1.27M2.09M1.77M1.57M2.42M2.61M
Total Non-Current Assets+17.04M17.71M17.14M20.69M24.09M26.26M61.16M93.74M103.79M
Property, Plant & Equipment13.23M13.5M12.91M16.42M18.81M20.86M54.79M80.59M83.59M
Fixed Asset Turnover1.50x2.57x4.74x5.46x4.50x6.07x2.95x2.05x1.99x
Goodwill255K465K465K465K465K465K465K465K1.21M
Intangible Assets2.1M3.4M3.44M3.44M4.15M4.37M4.61M7.99M11.68M
Long-Term Investments171K75K0000000
Other Non-Current Assets1.46M347K315K368K664K558K1.29M4.7M7.31M
Total Assets+29.56M57.09M116.57M116.53M156.39M139.53M211.06M268.64M346.83M
Asset Turnover0.67x0.61x0.53x0.77x0.54x0.91x0.77x0.61x0.48x
Asset Growth %-0.93%1.04%-0%0.34%-0.11%0.51%0.27%0.29%
Total Current Liabilities+54.57M57.44M16.45M23.24M25.9M31.89M38.96M57.15M68.28M
Accounts Payable7.28M9.13M6.24M10.37M9.72M14.47M20.03M41.62M44.76M
Days Payables Outstanding273.83196.2990.76109.02110.29127.99132.7261.16289.16
Short-Term Debt39.8M24.09M0000000
Deferred Revenue (Current)1000K1000K908K785K1000K769K1000K1000K1000K
Other Current Liabilities6.29M21.89M4.12M7.53M8.63M9.08M9.88M4.57M5.53M
Current Ratio0.23x0.69x6.05x4.12x5.11x3.55x3.85x3.06x3.56x
Quick Ratio0.14x0.46x4.54x2.89x4.21x2.66x2.91x1.67x2.41x
Cash Conversion Cycle29.24224.85375.91285.19235.46193.6189.58341.16362.59
Total Non-Current Liabilities+1.43M4.67M30.64M53.67M55.53M56.9M180.29M193.1M225.46M
Long-Term Debt0022.32M48.14M49.83M51.91M175.46M188.74M219.58M
Capital Lease Obligations0599K001.92M1.9M3.2M2.71M4.2M
Deferred Tax Liabilities003.58M000000
Other Non-Current Liabilities1.43M4.07M7.13M4.19M1.91M703K-44K147K554K
Total Liabilities56M62.11M47.09M76.92M81.43M88.79M219.25M250.25M293.74M
Total Debt+38.15M24.09M22.32M48.4M52.54M54.21M179.35M192.22M225.29M
Net Debt37.67M13.22M-30.32M10.74M-31.98M793K112.99M152.19M134.95M
Debt / Equity--0.32x1.22x0.70x1.07x-10.45x4.24x
Debt / EBITDA---------
Net Debt / EBITDA---------
Interest Coverage-4.64x-1.92x-2.71x-3.56x-2.98x-2.77x-3.37x-4.22x-2.40x
Total Equity+-26.43M-5.01M69.48M39.61M74.96M50.74M-8.19M18.39M53.09M
Equity Growth %-0.81%14.86%-0.43%0.89%-0.32%-1.16%3.25%1.89%
Book Value per Share-1.43-0.274.001.933.212.12-0.330.721.89
Total Shareholders' Equity-26.43M-5.01M69.48M39.61M74.96M50.74M-8.19M18.39M53.09M
Common Stock7.12M41.27M145.71M147.69M213.47M219.74M223.64M315.63M420.36M
Retained Earnings-32.98M-67.88M-88.97M-127.13M-165.25M-206.38M-281.59M-360.1M-444.69M
Treasury Stock-3.61M-6.46M-2.85M-2.85M-2.85M-2.85M-2.85M-2.85M-2.85M
Accumulated OCI076K449K691K2.87M3.66M2.71M1.96M3.29M
Minority Interest000000000

Cash Flow

Dec 2016Dec 2017Dec 2018Dec 2019Dec 2020Dec 2021Dec 2022Dec 2023Dec 2024
Cash from Operations+-14.27M-31.97M-33.88M-29.98M-12.51M-27.53M-52.17M-88.51M-58.52M
Operating CF Margin %-0.72%-0.92%-0.55%-0.33%-0.15%-0.22%-0.32%-0.54%-0.35%
Operating CF Growth %--1.24%-0.06%0.12%0.58%-1.2%-0.89%-0.7%0.34%
Net Income-22.16M-34.9M-21.1M-38.15M-38.12M-41.14M-75.21M-78.5M-84.6M
Depreciation & Amortization592K1.94M2.81M3.29M3.71M4.12M4.34M4.88M7.58M
Stock-Based Compensation3.13M3.3M7.32M6.53M5.72M10.41M13.36M14.86M15.37M
Deferred Taxes2.9M4.96M-13.94M02.48M7K86K-3.71M-2.18M
Other Non-Cash Items3.12M7.05M5.04M2.95M1.39M5.51M26.8M8.08M20.81M
Working Capital Changes-1.84M-14.32M-14.02M-4.6M12.31M-6.44M-21.54M-34.13M-15.5M
Change in Receivables-4.72M-6.91M-4.67M-5.51M3.81M-6.7M-12.33M-11.56M-26.28M
Change in Inventory-1.36M-6.44M-6.98M-3.37M4.79M-7.64M-10.9M-42.23M-471K
Change in Payables3.94M-878K-3.9M1.83M-910K4.96M4.38M18.96M6.67M
Cash from Investing+-10.76M-845K-5.73M-7.77M-5.56M-7.16M-34.79M-24.55M-15.61M
Capital Expenditures-10.55M-941K-1.77M-6.29M-3.91M-6.73M-34.27M-7.91M-6.11M
CapEx % of Revenue0.53%0.03%0.03%0.07%0.05%0.05%0.21%0.05%0.04%
Acquisitions---------
Investments---------
Other Investing-55K96K-3.96M-1.48M-1.65M-434K-525K-16.64M-9.45M
Cash from Financing+20.21M42.99M81.53M22.79M64.67M4.05M100.25M86.23M125.89M
Debt Issued (Net)---------
Equity Issued (Net)---------
Dividends Paid000000000
Share Repurchases---------
Other Financing7.92M24.53M81.84M-1.72M1.09M-356K-4K1.69M1.94M
Net Change in Cash---------
Free Cash Flow+-24.82M-32.91M-35.66M-36.98M-16.42M-34.26M-86.43M-113.06M-74.08M
FCF Margin %-1.25%-0.95%-0.58%-0.41%-0.19%-0.27%-0.53%-0.68%-0.45%
FCF Growth %--0.33%-0.08%-0.04%0.56%-1.09%-1.52%-0.31%0.34%
FCF per Share-1.34-1.78-2.06-1.80-0.70-1.43-3.53-4.42-2.63
FCF Conversion (FCF/Net Income)0.64x0.92x1.61x0.79x0.33x0.67x0.69x1.13x0.69x
Interest Paid02.86M5.38M5.95M6.96M6.93M5.36M5.69M9.81M
Taxes Paid0147K136K649K316K652K2.13M2.17M1.74M

Key Ratios

Metric201620172018201920202021202220232024
Return on Equity (ROE)---65.45%-69.94%-66.54%-65.46%-353.48%-1537.75%-236.67%
Return on Invested Capital (ROIC)-105.69%-154.14%-75.55%-51.84%-44.86%-39.9%-38.05%-35.42%-20.91%
Gross Margin50.99%51.04%59.01%61.25%62%67.42%65.92%64.78%65.97%
Net Margin-111.91%-100.62%-34.47%-42.59%-45.02%-32.47%-46.51%-47.53%-50.95%
Debt / Equity--0.32x1.22x0.70x1.07x-10.45x4.24x
Interest Coverage-4.64x-1.92x-2.71x-3.56x-2.98x-2.77x-3.37x-4.22x-2.40x
FCF Conversion0.64x0.92x1.61x0.79x0.33x0.67x0.69x1.13x0.69x
Revenue Growth-75.15%76.49%46.33%-5.46%49.61%27.64%2.13%0.53%

Revenue by Geography

201920202021202220232024
EMEA----80.15M78.21M
EMEA Growth------2.42%
Asia Pacific----33.95M48.41M
Asia Pacific Growth-----42.57%
Latin America27.99M21.51M38.23M52.44M48.89M35M
Latin America Growth--23.15%77.70%37.19%-6.77%-28.42%
North America-----4.41M
North America Growth------
Other Geographical Areas540K511K865K994K2.16M-
Other Geographical Areas Growth--5.37%69.28%14.91%117.00%-
Asia Pacific And Middle East24.82M24.99M35.68M59.56M--
Asia Pacific And Middle East Growth-0.67%42.80%66.94%--
Europe36.21M37.67M51.91M48.7M--
Europe Growth-4.02%37.82%-6.18%--

Frequently Asked Questions

Growth & Financials

Establishment Labs Holdings Inc. (ESTA) reported $191.0M in revenue for fiscal year 2024. This represents a 864% increase from $19.8M in 2016.

Establishment Labs Holdings Inc. (ESTA) grew revenue by 0.5% over the past year. Growth has been modest.

Establishment Labs Holdings Inc. (ESTA) reported a net loss of $83.0M for fiscal year 2024.

Dividend & Returns

Establishment Labs Holdings Inc. (ESTA) has a return on equity (ROE) of -236.7%. Negative ROE indicates the company is unprofitable.

Establishment Labs Holdings Inc. (ESTA) had negative free cash flow of $77.5M in fiscal year 2024, likely due to heavy capital investments.

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