Establishment Labs Revenue Jumps 33.9% to $72 Million Despite Wider Per-Share Loss
Key Facts
Establishment Labs reported revenue of $72.0 million in the third quarter ended September 30, 2026, up 33.9% from $53.8 million a year earlier, while posting a GAAP net loss of $10.7 million, or $0.35 per share. Revenue topped analysts’ estimate of $66.79 million, while the per-share loss was wider than the estimate of $0.26, according to the earnings call report published on the announcement date. The company said quarterly results reflected strong global revenue growth and increased operating leverage, alongside a milestone in cash generation. The picture was mixed: sales growth and improvement in some operating and cash measures, alongside a continuing net loss and per-share earnings that missed expectations. The company recorded a loss of $11.1 million, or $0.38 per share, in the same period a year earlier.
The U.S. market drove a large part of revenue growth, with sales there rising 119.0% to $26.0 million, while revenue outside the United States increased 9.7% to $46.0 million. International business therefore remained larger in value, while U.S. growth was much faster during the quarter. Revenue from the minimally invasive products platform rose 124.0% year over year to about $9 million, making it one of the fastest-growing reported drivers. The company expanded its U.S. commercial presence to more than 2,100 accounts and said more than 400 plastic surgeons had received training on Preservé. In the second quarter, revenue was $67.5 million, up 31.7% year over year, while U.S. sales reached $24.7 million, up 26% from the first quarter.
GAAP gross margin was 69.1%, compared with 70.1% in the third quarter of the previous year. The company said the figure included $1.3 million in restructuring-related inventory charges; excluding those, adjusted gross margin was 70.8%, up 70 basis points year over year. In the second quarter, gross margin had risen to 70.6% from 68.8% in the corresponding period of 2025, with the company then attributing the improvement mainly to geographic and sales-channel mix. GAAP operating expenses were about $52.3 million, up from $41.7 million a year earlier. But adjusted operating expenses, excluding litigation, restructuring and relocation costs, fell to 68.8% of revenue from 77.6% in the corresponding period, reflecting an improvement as a share of sales despite an increase in the total amount.
On liquidity, the company reported about $7.7 million in cash flow from operating activities and positive free cash flow of $5.1 million, which it described as the first positive free-cash-flow quarter in its history. Adjusted EBITDA also rose to $6.4 million, or 8.9% of revenue, compared with $1.2 million and 2.2% a year earlier. These measures came alongside the continuing net loss, adding cash generation and improved adjusted operating profitability to investors’ assessment of the results. The company also announced a new supply agreement with NuSil, which it said would support long-term manufacturing capacity and future growth. In premarket trading on October 29, the stock stood at $68.93, down 0.06% from the previous session’s close of $68.97, according to Investing.com.
Establishment Labs raised its fiscal 2026 revenue outlook to more than $274 million, from its previous range of $269 million to $271 million. It also raised its full-year revenue target for the minimally invasive products platform to more than $40 million, compared with a previous target above $35 million. The company had raised its annual outlook in the second quarter to a range of $269–271 million, alongside reporting quarterly revenue of $67.5 million. For fiscal 2027, management said it expects 25% growth and positive cash flow. The chief financial officer said a 50 to 100 basis point improvement in gross margin in 2027 remained reasonable, based partly on geographic and sales-channel mix.
On the product front, the company said it received FDA approval for additional smaller sizes of Motiva implants, while review of the product application for breast reconstruction was proceeding as expected. This path links current commercial expansion with the potential to broaden product uses, without the company specifying an additional review timeline in its statement. Management said it would continue investing in innovation and commercial expansion alongside revenue growth and improved operating leverage. The announced fiscal 2027 outlook, including growth and positive cash flow, remains the company’s furthest-out time frame in the results announcement. For fiscal 2026, management raised its annual revenue estimate following third-quarter performance.