Establishment Labs Holdings Stock Earnings Reports

Establishment Labs reported a strong Q1 2026: revenue of $59.9M (+44.7% y/y), adjusted EBITDA of $1.2M (third consecutive quarter positive), and gross margin expansion to 70.7% (up 350 bps y/y). The U.S. business is the primary growth driver, generating $19.6M in the quarter (216% y/y growth) and now representing ~32.7% of revenue, aided by the March U.S. launch of the minimally invasive Preserve procedure and continued Motiva account expansion (now >1,700 accounts). Minimally invasive offerings (Preserve and Mia) produced $9.1M in Q1 and management now expects >$35M for 2026 (up from prior $30M). The company raised full-year revenue guidance to $266.5M–$268.5M (≈26%–27% growth vs. 2025). Cash decreased to $68.1M due to U.S. investments and a Benelux acquisition payment, but management completed a debt refinancing with PIK interest that they say supports a path to cash-flow positivity in H2 2026 and eliminated near-term equity financing plans. Key operational notes: continued R&D and product pipeline (reconstruction submission to FDA, Zen temperature CE Mark/biosensing, GEM development), ongoing discussions for a long-term supply/co-development agreement with silicone supplier NuSil, and limited current exposure to the Middle East (~<5% of revenue). Management remains conservative on macro/geopolitical risks but is encouraged by strong U.S. momentum, higher realized price points from minimally invasive procedures, and improving operating leverage.