Revenue growth accelerated to 31.7% YoY in 2026Q2 with gross margin expanding to 70.6%, yet operating margin remains negative at -6.4%, reflecting persistent SG&A dominance.
Establishment Labs Holdings Inc. (ESTA) annual income statement — 10-year revenue, gross profit & net income history
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 |
|---|
| Sales/Revenue | 245.82M | 211.08M | 166.03M | 165.15M | 161.7M | 126.68M | 84.68M | 89.56M | 61.21M | 34.68M | 19.8M |
| Revenue Growth % | 38.55% | 27.14% | 0.53% | 2.13% | 27.64% | 49.61% | -5.46% | 46.33% | 76.49% | 75.15% | - |
| Cost of Goods Sold | 72.54M | 64.77M | 56.5M | 58.17M | 55.1M | 41.28M | 32.17M | 34.7M | 25.09M | 16.98M | 9.71M |
| COGS % of Revenue | - | 30.68% | 34.03% | 35.22% | 34.08% | 32.58% | 38% | 38.75% | 40.99% | 48.96% | 49.01% |
| Gross Profit | 173.27M | 146.31M | 109.53M | 106.98M | 106.59M | 85.4M | 52.5M | 54.86M | 36.12M | 17.7M | 10.1M |
| Gross Margin % | 70.49% | 69.32% | 65.97% | 64.78% | 65.92% | 67.42% | 62% | 61.25% | 59.01% | 51.04% | 50.99% |
| Gross Profit Growth % | - | 33.58% | 2.38% | 0.36% | 24.81% | 62.67% | -4.3% | 51.89% | 104.03% | 75.34% | - |
| Operating Expenses | 192.03M | 185.32M | 159.51M | 172M | 146.25M | 110.54M | 80.42M | 85.8M | 59.98M | 37.69M | 25.93M |
| OpEx % of Revenue | - | 87.8% | 96.08% | 104.15% | 90.45% | 87.26% | 94.97% | 95.8% | 98% | 108.66% | 130.95% |
| Selling, General & Admin | 124.8M | 165.07M | 139.81M | 145.57M | 125.98M | 92.23M | 66.63M | 70.81M | 47.3M | 30.82M | 23.19M |
| SG&A % of Revenue | - | 78.2% | 84.21% | 88.15% | 77.91% | 72.8% | 78.68% | 79.06% | 77.27% | 88.87% | 117.11% |
| Research & Development | 20.33M | 20.25M | 19.71M | 26.43M | 20.27M | 18.32M | 13.79M | 14.99M | 12.69M | 6.86M | 2.74M |
| R&D % of Revenue | - | 9.59% | 11.87% | 16% | 12.53% | 14.46% | 16.29% | 16.74% | 20.73% | 19.79% | 13.84% |
| Other Operating Expenses | 1000K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Operating Income | -18.76M | -39.01M | -49.99M | -65.03M | -39.66M | -25.14M | -27.92M | -30.94M | -23.86M | -19.98M | -15.83M |
| Operating Margin % | -7.63% | -18.48% | -30.11% | -39.37% | -24.53% | -19.84% | -32.97% | -34.55% | -38.99% | -57.62% | -79.96% |
| Operating Income Growth % | - | 21.96% | 23.13% | -63.97% | -57.75% | 9.94% | 9.78% | -29.66% | -19.42% | -26.21% | - |
| EBITDA | -5.55M | -28.53M | -42.41M | -60.14M | -35.49M | -21.03M | -24.25M | -27.64M | -21.06M | -18.04M | -15.24M |
| EBITDA Margin % | -2.26% | -13.52% | -25.54% | -36.42% | -21.95% | -16.6% | -28.64% | -30.86% | -34.41% | -52.03% | -76.97% |
| EBITDA Growth % | 89.56% | 32.72% | 29.48% | -69.47% | -68.72% | 13.27% | 12.26% | -31.22% | -16.74% | -18.39% | - |
| D&A (Non-Cash Add-back) | 13.21M | 10.47M | 7.58M | 4.88M | 4.17M | 4.11M | 3.66M | 3.3M | 2.8M | 1.94M | 592K |
| EBIT | -19.9M | -32.77M | -63.8M | -63.19M | -61.06M | -30.65M | -28.64M | -28.81M | -12.07M | -24.37M | -18.61M |
| Net Interest Income | -27.43M | -24.83M | -19.35M | -14.37M | -11.67M | -9.04M | -9.36M | -8.69M | -8.8M | -10.4M | -3.37M |
| Interest Income | 144K | 423K | 1.48M | 1.02M | 87K | 23K | 15K | 4K | 16K | 19K | 44K |
| Interest Expense | 27.57M | 25.26M | 20.83M | 15.39M | 11.76M | 9.06M | 9.37M | 8.7M | 8.81M | 10.42M | 3.41M |
| Other Income/Expense | -28.72M | -19.01M | -34.64M | -13.56M | -33.17M | -14.57M | -10.1M | -6.57M | 2.98M | -14.81M | -6.19M |
| Pretax Income | -47.47M | -58.02M | -84.63M | -78.58M | -72.82M | -39.71M | -38.02M | -37.51M | -20.88M | -34.79M | -22.02M |
| Pretax Margin % | -19.31% | -27.49% | -50.97% | -47.58% | -45.04% | -31.35% | -44.9% | -41.88% | -34.12% | -100.32% | -111.23% |
| Income Tax | -8.58M | -6.96M | -32K | -81K | 2.38M | 1.43M | 104K | 640K | 215K | 105K | 134K |
| Effective Tax Rate % | 18.08% | 11.99% | 0.04% | 0.1% | -3.28% | -3.59% | -0.27% | -1.71% | -1.03% | -0.3% | -0.61% |
| Net Income | -38.89M | -51.06M | -84.6M | -78.5M | -75.21M | -41.14M | -38.12M | -38.15M | -21.1M | -34.9M | -22.16M |
| Net Margin % | -15.82% | -24.19% | -50.95% | -47.53% | -46.51% | -32.47% | -45.02% | -42.59% | -34.47% | -100.62% | -111.91% |
| Net Income Growth % | 56.06% | 39.64% | -7.76% | -4.38% | -82.82% | -7.92% | 0.08% | -80.82% | 39.54% | -57.48% | - |
| Net Income (Continuing) | -38.89M | -51.06M | -84.6M | -78.5M | -75.21M | -41.14M | -38.12M | -38.15M | -21.1M | -34.9M | -22.16M |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| EPS (Diluted) | -1.29 | -1.72 | -3.00 | -3.07 | -3.08 | -1.72 | -1.63 | -1.86 | -1.22 | -1.89 | -1.20 |
| EPS Growth % | 57.1% | 42.67% | 2.28% | 0.32% | -79.07% | -5.52% | 12.37% | -52.46% | 35.45% | -57.5% | - |
| EPS (Basic) | - | -1.72 | -3.00 | -3.07 | -3.08 | -1.72 | -1.63 | -1.86 | -1.22 | -2.33 | -1.20 |
| Diluted Shares Outstanding | 30.12M | 29.62M | 28.16M | 25.6M | 24.46M | 23.97M | 23.32M | 20.54M | 17.35M | 18.49M | 18.49M |
| Basic Shares Outstanding | 30.12M | 29.62M | 28.16M | 25.6M | 24.46M | 23.97M | 23.32M | 20.54M | 17.35M | 14.98M | 18.49M |
| Dividend Payout Ratio | - | - | - | - | - | - | - | - | - | - | - |
Quick answers to the most common questions about buying ESTA stock.
For fiscal year 2025, Establishment Labs Holdings Inc. (ESTA) reported total revenue of $211.1M. This represents a 966.0% increase compared to $19.8M in 2016.
Establishment Labs Holdings Inc. (ESTA) reported a net loss of $51.1M for the fiscal year ending 2025.
Establishment Labs Holdings Inc. (ESTA) reported an operating income of $-39.0M, resulting in an operating profit margin of -18.5%. This margin reflects the operational efficiency of the business before interest and taxes.
Establishment Labs Holdings Inc. (ESTA) generated $146.3M in gross profit for the year, representing a gross profit margin of 69.3%. This demonstrates the company's core pricing power and production efficiency.
Key Metrics
Top Statement Risk
US launch delays and cash burn
Metrics are mathematically derived from official filings.
Accelerating Growth Ahead of US Entry
Revenue growth accelerated to 31.7% YoY in 2026Q2, up from 16.3% in 2025Q2, driven by international expansion and new product adoption, per company filings.
The sequential acceleration from 16.3% to 31.7% YoY suggests that the company is gaining traction in existing markets, likely benefiting from the shift away from textured implants. However, this growth is entirely international, as US revenue remains absent, which may imply a ceiling until FDA approval is secured. The durability of this growth will depend on the company's ability to maintain surgeon conversion rates and defend against competitive responses.
Gross Margin Expansion Reflects Premium Positioning
Gross margin improved from 65.6% in 2024Q1 to 70.6% in 2026Q2, indicating pricing power and manufacturing efficiencies, as reported in quarterly statements.
The 500 basis point expansion in gross margin over the period suggests that the company's proprietary SmoothSilk technology commands a premium and that production at the Costa Rican facility is scaling efficiently. This margin level is comparable to peers like ALGN (68.3%) and INMD (78.5%), but the company's operating margin remains deeply negative, indicating that the gross margin is not yet translating to profitability. The sustainability of this margin will be tested if input costs rise or if competitive pressures force price concessions.
Operating Leverage Emerging as Losses Narrow
Operating margin improved from -41.9% in 2024Q4 to -6.4% in 2026Q2, as revenue growth outpaced SG&A growth, according to income statement data.
The dramatic improvement in operating margin, despite SG&A remaining elevated, suggests that the company is beginning to realize operating leverage. Revenue grew 51.7% from 2024Q4 to 2026Q2, while SG&A grew only 0.7% over the same period, indicating that the heavy investment in sales force and US pre-launch activities is stabilizing. However, the absolute level of SG&A remains high, and investors should monitor whether this leverage continues as the company scales, or if additional investments are needed for the US launch.
Net Losses Narrow but EPS Remains Opaque
Net margin improved from -77.6% in 2024Q4 to -17.4% in 2026Q2, but EPS was undisclosed for the latest quarter, per recent earnings reports.
The narrowing net loss is a positive sign, but the lack of disclosed EPS for 2026Q2, despite a revenue beat and raised guidance, introduces uncertainty about the bottom-line trajectory. Stock-based compensation has been volatile, with a negative SBC in 2025Q4, which may distort reported net income. Investors should focus on cash burn and the sustainability of the improvement, as the company continues to fund heavy R&D and SG&A ahead of a potential US market entry.
SG&A Dominates Cost Structure, R&D Stable
SG&A averaged $40.6M per quarter over the last five quarters, versus R&D averaging $5.1M, indicating a sales-driven growth strategy, as per financial statements.
The cost structure is heavily weighted toward SG&A, which is likely funding the expansion of the direct sales force and pre-commercial activities for the US market. R&D spending has been relatively flat, suggesting that the company is not significantly increasing investment in new product development, but rather focusing on commercial execution. The efficiency of SG&A spending will be critical; if it does not translate into sustained revenue growth, the company may face margin compression.
2025Q4 Marks Turning Point in Profitability
In 2025Q4, net loss narrowed to -$2.6M from -$34.5M in 2024Q4, a dramatic improvement driven by revenue growth and cost control, as reported in quarterly results.
The 2025Q4 quarter appears to be a pivotal inflection point, with net margin improving to -4.0% from -77.6% a year earlier. This was driven by a 45.2% YoY revenue increase and a significant reduction in operating losses, despite a one-time negative SBC of -$2.9M. The improvement suggests that the company's scale is beginning to offset its fixed cost base, but the sustainability of this trend will depend on continued revenue growth and disciplined expense management.
What Could Undermine the Growth Story
Despite revenue growth, the company's negative operating margin of -6.4% and undisclosed EPS raise concerns about profitability, while reliance on international markets exposes it to pricing pressures.
Short-sellers might argue that the company's growth is unprofitable and that the lack of US revenue limits its ability to achieve the high margins typical of the US market. The negative net margin of -17.4% in 2026Q2, despite a 70.6% gross margin, indicates that SG&A is consuming all gross profit and more. Additionally, the company's debt-to-equity ratio of 11.23% and negative cash flow suggest that it may need to raise capital, potentially diluting shareholders. If the US launch is delayed or fails, the company could face a re-rating to lower-growth, international-only device makers.