Establishment Labs reported its fourth‑quarter 2025 results on February 24 2026, delivering a quarterly revenue of $64.6 million—up 45.2% from $44.5 million in Q4 2024—and a net loss from operations of $3.9 million, a 79% reduction from the $18.7 million loss reported a year earlier.
The company’s earnings per share came in at $‑0.09, beating the consensus estimate of $‑0.22 by $0.13. The beat was driven by operational leverage and a favorable mix of higher‑margin U.S. Motiva sales, which totaled $17.3 million in the quarter and $45.6 million for the full year.
Gross margin expanded to 70.5% in Q4 2025, up from 68.5% in Q4 2024, as the geographic mix shifted toward the United States and the company was able to maintain pricing power. Adjusted EBITDA turned positive at $5.5 million, compared with a loss of $13.1 million in the same quarter a year earlier, reflecting both revenue growth and margin improvement.
Management highlighted the strength of the U.S. market, noting that "Q4 2025 was another standout quarter for Establishment Labs. Fourth quarter revenue was $64.6 million, an increase of 45.2% versus Q4 2024, including Motiva revenue in the US of $17.3 million. This brings our 2025 total revenue of $211.1 million, an increase of 27.2% over 2024. US Motiva revenue in 2025 was $45.6 million, a number that I'm sure significantly exceeded everyone's expectations. As our business scaled, the operational leverage that we've been talking about is coming into focus."
The company also reaffirmed its 2026 revenue guidance at $264 million to $266 million, implying a 25.1% to 26.0% growth over 2025. It reiterated a target of at least 25% revenue growth in 2027 and projected its first quarter of positive cash flow in 2026 and a full‑year positive cash flow in 2027. "We are positioned for our first quarter of positive cash flow in 2026, and full year of positive cash flow in 2027," said CEO Peter Caldini.
Investors remained cautious, focusing on the company’s ongoing GAAP losses and valuation multiples, which tempered enthusiasm for the earnings beat. The company’s management transition—Cassandra Harris joining as the new CFO and Rajbir Denhoy moving to SVP, Global Strategy—was also noted, underscoring a shift in the finance leadership team.
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