ESTABLISHMENT LABS HOLDINGS INC.
ESTA · Orthopedic, Prosthetic & Surgical Appliances & Supplies · 29.4M shares · +6%/yr ↑ dilution · EDGAR filings ↗
Net buyback after stock comp: -$10M (gross $5M, SBC $14M)
Reference price $72.89 · est. market cap ~$2.1B — last insider sale, 2026-05-28 (estimated from the dated SEC Form 4 price × shares outstanding — not a live quote)
Grade
D52Establishment Labs — breast-implant (Motiva) medtech, growing but loss-making and levered.
Strengths
- High gross margin (69%, 77th pct); strong liquidity (current 3.0); US-launch optionality
Risks
- Operating losses; very high leverage (D/E 10.5, 100th)
- Cash burn; commercialization/competition risk
Notable findings
- High leverageHigh leverage (debt/equity 10.51)
- Net lossNet loss (net margin -24.2%)
- Cash burnNegative free cash flow (-56.9M)
- Insider sellingInsider selling — 27 open-market sale(s) by 2 insider(s) (cluster of 2 insiders, ~$35M, last 6mo) Form 4 ↗
Quarterly revenue
Last 4 quarters · from SEC filings.
Key metrics
Gross margin
69.3%
Operating margin
-18.5%
Net margin
-24.2%
Return on equity
-216.9%
Return on assets
-14.3%
ROIC
-11.4%
Revenue growth (QoQ)
-7.3%
Debt / equity
10.5×
Current ratio
3.0×
Free cash flow
-$57M
EBITDA
-$33M
Tangible book value
$12M
Cash & investments
$76M
Cash runway
5q
Stock comp / revenue
5.4%
Insider transactions · last 18 months
| Date | Insider | Type | Shares | Price |
|---|---|---|---|---|
| 2026-05-28 | JW Asset Management, LLC | Sell | 65K | $72.89 |
| 2026-05-27 | JW Asset Management, LLC | Sell | 113 | $72.50 |
| 2026-05-26 | JW Asset Management, LLC | Sell | 25K | $74.39 |
| 2026-05-22 | Slotkin Bryan | Grant | 2.4K | — |
| 2026-05-22 | SCHUTTER EDWARD J | Grant | 2.4K | — |
| 2026-05-22 | LEWIN NICHOLAS SHERIDAN | Grant | 2.4K | — |
| 2026-05-22 | Custin Ann | Grant | 2.4K | — |
| 2026-05-22 | Gillin Leslie | Grant | 2.4K | — |
| 2026-05-21 | JW Asset Management, LLC | Sell | 17K | $71.40 |
| 2026-05-20 | JW Asset Management, LLC | Sell | 3.6K | $70.56 |
| 2026-05-06 | Chacon Quiros Juan Jose | Sell | 12K | $76.10 |
| 2026-05-06 | Chacon Quiros Juan Jose | Sell | 93K | $75.33 |
| 2026-05-06 | JW Asset Management, LLC | Sell | 60K | $75.62 |
| 2026-05-04 | Chacon Quiros Juan Jose | Sell | 7.7K | $70.47 |
| 2026-05-04 | Chacon Quiros Juan Jose | Sell | 100 | $71.34 |
| 2026-05-01 | Chacon Quiros Juan Jose | Sell | 26K | $71.18 |
| 2026-05-01 | Chacon Quiros Juan Jose | Sell | 41K | $70.52 |
| 2026-04-27 | Chacon Quiros Juan Jose | Sell | 1.0K | $66.46 |
| 2026-04-27 | Chacon Quiros Juan Jose | Sell | 165 | $67.14 |
| 2026-04-27 | Chacon Quiros Juan Jose | Sell | 1.0K | $65.91 |
| 2026-04-24 | Chacon Quiros Juan Jose | Sell | 23K | $65.66 |
| 2026-04-24 | Chacon Quiros Juan Jose | Sell | 7.6K | $66.13 |
| 2026-04-23 | Chacon Quiros Juan Jose | Sell | 400 | $67.36 |
| 2026-04-23 | Chacon Quiros Juan Jose | Sell | 6.8K | $66.20 |
| 2026-04-23 | Chacon Quiros Juan Jose | Sell | 31K | $65.33 |
| 2026-04-23 | Chacon Quiros Juan Jose | Sell | 4.9K | $64.83 |
| 2026-04-14 | Chacon Quiros Juan Jose | Sell | 38K | $65.23 |
| 2026-04-02 | SCHUTTER EDWARD J | Option exercise | 37K | — |
| 2026-03-31 | Custin Ann | Grant | 363 | $56.78 |
| 2026-03-31 | Gillin Leslie | Grant | 297 | $56.78 |
| 2026-03-31 | Slotkin Bryan | Grant | 286 | $56.78 |
| 2026-03-31 | LEWIN NICHOLAS SHERIDAN | Grant | 440 | $56.78 |
| 2026-03-31 | SCHUTTER EDWARD J | Grant | 330 | $56.78 |
| 2026-03-25 | Chacon Quiros Juan Jose | Sell | 3.6K | $60.08 |
| 2026-03-23 | Chacon Quiros Juan Jose | Sell | 1.5K | $62.62 |
| 2026-03-23 | Chacon Quiros Juan Jose | Other | 179K | — |
| 2026-03-23 | Chacon Quiros Juan Jose | Other | 179K | — |
| 2026-03-23 | Chacon Quiros Juan Jose | Sell | 31K | $60.23 |
| 2026-03-23 | Chacon Quiros Juan Jose | Sell | 787 | $61.70 |
| 2026-03-23 | Chacon Quiros Juan Jose | Sell | 200 | $63.01 |
| 2026-03-09 | HARRIS CASSANDRA | Grant | 7.4K | — |
| 2026-03-06 | Mansbach Samuel Ross | Tax withheld | 657 | $70.41 |
| 2026-02-18 | Caldini Filippo | Grant | 8.2K | — |
| 2026-02-18 | Caldini Filippo | Grant | 14K | — |
| 2026-02-16 | Mansbach Samuel Ross | Grant | 4.1K | — |
| 2025-12-31 | Slotkin Bryan | Grant | 222 | $72.88 |
| 2025-12-31 | Custin Ann | Grant | 282 | $72.88 |
| 2025-12-31 | Gillin Leslie | Grant | 231 | $72.88 |
| 2025-12-31 | LEWIN NICHOLAS SHERIDAN | Grant | 343 | $72.88 |
| 2025-12-31 | SCHUTTER EDWARD J | Grant | 257 | $72.88 |
| 2025-12-17 | Chacon Quiros Juan Jose | Gift | 50K | — |
| 2025-11-10 | JW Asset Management, LLC | Sell | 11K | $67.07 |
| 2025-11-07 | JW Asset Management, LLC | Sell | 2.5K | $65.09 |
| 2025-11-06 | JW Asset Management, LLC | Sell | 7.6K | $65.00 |
| 2025-09-30 | LEWIN NICHOLAS SHERIDAN | Grant | 609 | $40.99 |
| 2025-09-30 | SCHUTTER EDWARD J | Grant | 457 | $40.99 |
| 2025-09-30 | Custin Ann | Grant | 503 | $40.99 |
| 2025-09-30 | Gillin Leslie | Grant | 411 | $40.99 |
| 2025-09-30 | Slotkin Bryan | Grant | 396 | $40.99 |
| 2025-08-14 | LEWIN NICHOLAS SHERIDAN | Buy | 2.6K | $37.85 |
| 2025-08-13 | LEWIN NICHOLAS SHERIDAN | Buy | 2.3K | $34.30 |
| 2025-08-11 | Caldini Filippo | Buy | 2.9K | $35.20 |
| 2025-08-11 | Caldini Filippo | Buy | 2.9K | $35.20 |
| 2025-08-03 | Chacon Quiros Juan Jose | Grant | 10K | — |
| 2025-07-01 | JW Asset Management, LLC | Sell | 9.7K | $44.38 |
| 2025-06-30 | SCHUTTER EDWARD J | Grant | 439 | $42.71 |
| 2025-06-30 | Slotkin Bryan | Grant | 380 | $42.71 |
| 2025-06-30 | Custin Ann | Grant | 510 | $42.71 |
| 2025-06-30 | Gillin Leslie | Grant | 395 | $42.71 |
| 2025-06-30 | LEWIN NICHOLAS SHERIDAN | Grant | 585 | $42.71 |
| 2025-06-13 | SCHUTTER EDWARD J | Other | 43K | — |
| 2025-06-09 | SCHUTTER EDWARD J | Gift | 59K | — |
| 2025-06-04 | SCHUTTER EDWARD J | Gift | 73K | — |
| 2025-05-23 | SCHUTTER EDWARD J | Grant | 3.4K | — |
| 2025-05-23 | Custin Ann | Grant | 3.4K | — |
| 2025-05-23 | Gillin Leslie | Grant | 3.4K | — |
| 2025-05-23 | Slotkin Bryan | Grant | 3.4K | — |
| 2025-05-23 | Chacon Quiros Juan Jose | Grant | 3.4K | — |
| 2025-05-23 | LEWIN NICHOLAS SHERIDAN | Grant | 3.4K | — |
| 2025-05-14 | Caldini Filippo | Grant | 6.9K | — |
| 2025-03-31 | Gillin Leslie | Grant | 413 | $40.81 |
| 2025-03-31 | Custin Ann | Grant | 474 | $40.81 |
| 2025-03-31 | Slotkin Bryan | Grant | 398 | $40.81 |
| 2025-03-31 | LEWIN NICHOLAS SHERIDAN | Grant | 612 | $40.81 |
| 2025-03-31 | SCHUTTER EDWARD J | Grant | 459 | $40.81 |
| 2025-03-13 | Denhoy Raj | Grant | 11K | — |
| 2025-03-13 | Caldini Filippo | Grant | 17K | — |
| 2025-03-13 | Caldini Filippo | Tax withheld | 770 | $34.82 |
| 2025-03-13 | Mansbach Samuel Ross | Grant | 8.0K | — |
| 2025-03-06 | Mansbach Samuel Ross | Tax withheld | 728 | $42.08 |
| 2025-03-06 | Denhoy Raj | Tax withheld | 985 | $42.08 |
| 2024-12-31 | Custin Ann | Grant | 420 | $46.07 |
| 2024-12-31 | Gillin Leslie | Grant | 366 | $46.07 |
| 2024-12-31 | Slotkin Bryan | Grant | 352 | $46.07 |
| 2024-12-31 | LEWIN NICHOLAS SHERIDAN | Grant | 542 | $46.07 |
| 2024-12-31 | CONDON DENNIS E | Grant | 298 | $46.07 |
| 2024-12-31 | SCHUTTER EDWARD J | Grant | 406 | $46.07 |
All non-derivative Form 4 activity (SEC), newest first.
Notable events (8-K)
| Date | Items | |
|---|---|---|
| 2026-05-22 | Shareholder voteExhibits | filing ↗ |
| 2026-05-06 | ResultsExhibits | filing ↗ |
| 2026-04-30 | Material agreementDebt obligation | filing ↗ |
| 2026-02-24 | ResultsExhibits | filing ↗ |
| 2026-01-14 | Reg FDExhibits | filing ↗ |
| 2026-01-12 | ResultsExhibits | filing ↗ |
| 2025-11-05 | ResultsExhibits | filing ↗ |
| 2025-10-03 | Material agreementDebt obligationExhibits | filing ↗ |
Recent filings
| Form | Filed | Period | Accession |
|---|---|---|---|
| 8-K | 2026-05-22 | 2026-05-22 | 0001688757-26-000044 ↗ |
| 10-Q | 2026-05-08 | 2026-03-31 | 0001688757-26-000041 ↗ |
| 8-K | 2026-05-06 | 2026-05-06 | 0001688757-26-000038 ↗ |
| 8-K | 2026-04-30 | 2026-04-30 | 0001688757-26-000033 ↗ |
| 10-K | 2026-02-27 | 2025-12-31 | 0001688757-26-000022 ↗ |
| 8-K | 2026-02-24 | 2026-02-24 | 0001688757-26-000014 ↗ |
| 8-K | 2026-01-14 | 2026-01-14 | 0001688757-26-000008 ↗ |
| 8-K | 2026-01-12 | 2026-01-12 | 0001688757-26-000004 ↗ |
| 10-Q | 2025-11-07 | 2025-09-30 | 0001688757-25-000065 ↗ |
| 8-K | 2025-11-05 | 2025-11-05 | 0001628280-25-049261 ↗ |
| 8-K | 2025-10-03 | 2025-09-29 | 0001688757-25-000062 ↗ |
| 10-Q | 2025-08-07 | 2025-06-30 | 0001688757-25-000060 ↗ |