ESTA Turns Adjusted EBITDA Positive Ahead of Schedule as Gross Margins Hit 70.1%
Third Quarter Highlights Show Expansion Across Core Metrics
Establishment Labs (NASDAQ: ESTA) posted robust third-quarter results, signaling operational improvement and rising market share in the global breast aesthetics industry. Worldwide revenue reached $53.8 million, a 33.8% increase from a year earlier, with $11.9 million in U.S. Motiva sales and accelerated momentum in the U.S. market—outpacing a seasonally weaker sector.
Management raised full-year revenue guidance to exceed $210 million, while also noting strong progress in product innovation and geographic expansion. The company now targets an approximate 20% share of the U.S. breast augmentation market by year-end, alongside meaningfully exceeding $40 million in U.S. Motiva sales—previously set as the 2025 milestone.
Profitability Milestone: Positive Adjusted EBITDA Achieved
A standout metric: ESTA delivered positive adjusted EBITDA of $1.17 million, reversing a loss of $7.02 million from the same period last year and beating both internal and Street expectations. The company reduced its operating loss to $4.03 million from $13.14 million, and gross profit margin climbed to 70.1%—up sharply from 63.9% a year ago and 68.8% last quarter.
This performance was largely fueled by favorable geographic mix and higher average selling prices, highlighting ESTA’s ability to extract higher value per procedure and benefit from growing brand preference. Meanwhile, net loss narrowed to $11.15 million from $16.68 million, underscoring greater cost discipline and operating leverage as sales scale.
| Key Metric | Q3 2025 | Q3 2024 | Change (%) |
|---|---|---|---|
| Revenue (M) | $53.78 | $40.23 | +33.8% |
| Gross Margin | 70.1% | 63.9% | +6.2 pts |
| Operating Loss (M) | ($4.03) | ($13.14) | -69.3% |
| Net Loss (M) | ($11.15) | ($16.68) | -33.2% |
| Adjusted EBITDA (M) | $1.17 | ($7.02) | N/A |
| Cash Balance (M) | $70.62 | N/A | N/A |
Strong Margins and Cash Discipline Fuel Growth Prospects
Gross margins hit 70.1%—a significant uptick—helped by premium pricing and market mix. Operating expenses climbed slightly to $41.72 million, driven by U.S. commercial investments. Importantly, R&D spending decreased year-over-year, reflecting the timing of clinical trial investments.
The company ended the quarter with a $70.62 million cash balance, though this represented a decrease of $19.72 million year-to-date. Notably, the third quarter saw a cash increase of $16 million, driven by financing activity; operating outflows moderated, with cash decreasing $8.5 million excluding financing inflows. These trends set the stage for ESTA’s near-term goal: reaching cash flow positive in 2026.
Leadership Perspective: Poised for Continued U.S. Growth
CEO Peter Caldini pointed out the company’s performance outstripped a U.S. market that can decline up to 30% in Q3 due to seasonality. Looking ahead, management expects accelerated demand in Q4, traditionally the strongest quarter for breast augmentation. New platform innovations—including the minimally invasive Mia Femtech® and GEM®—are also expected to drive further share gains and long-term value for both patients and providers.
Takeaway: Key Financials Suggest Continued Upside Into 2026
With gross margin expansion, positive adjusted EBITDA ahead of plan, and improved cost discipline, ESTA enters Q4 with momentum and aims to capture an even greater share of the U.S. breast augmentation market. Investors tracking operational inflection points will find ESTA’s trajectory notable: strategic commercial investment and innovation are translating into real financial progress, and the company has signaled confidence in its full-year outlook and path to profitability.
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