Q2 2026 Establishment Labs Holdings Inc Earnings Call Transcript
Key Points
- Revenue grew 31.7% year-over-year to $67.5 million, with U.S. sales surging 140.9% to $24.7 million.
- Adjusted EBITDA turned positive at $3.7 million, a $12.2 million improvement from the prior year.
- Minimally invasive platform (Mia and Preservé) generated $12.1 million in revenue, approaching 15% of global sales and expanding the total addressable market.
- Surpassed 100,000 Motiva implants in the U.S. in under 21 months, with over 2,000 accounts and 75% of surgeons reporting patient brand requests.
- Raised full-year revenue guidance to $269-$271 million and expect to be free cash flow positive in the second half of 2026.
- Preservé surgeon training exceeded expectations (300+ certified, targeting 500 for the year), with procedures commanding 30-50% premium pricing.
- Strong OUS performance in direct markets, especially Europe (16% growth), with diversified revenue reducing exposure to volatile regions.
- OUS revenue growth was only 4.4%, impacted by the Middle East conflict, which has reduced orders and is expected to remain weak for the rest of the year.
- Third quarter is expected to be seasonally weak, with summer vacations affecting both U.S. and OUS sales.
- Reconstruction revenue is not expected to be material until 2027, with FDA approval timing still uncertain.
- Operating expenses, including one-time refinancing costs, reached $52 million, though adjusted for these, growth was modest.
- The company faces ongoing macroeconomic and geopolitical uncertainty across several regions, which could impact future demand.
- GEM, the gluteal augmentation product, is not expected to contribute to U.S. revenue until 2028, limiting near-term growth catalysts.
- Cash position remains relatively low at $71.2 million, though management states it is sufficient without future equity raises.
Good morning and welcome to Establishment Labs second quarter 2026 earnings call. (Operator Instructions)I will now turn the call over to Malavika William, VP, Global Head of Corporate Communications and Marketing. Please go ahead.
Thank you, operator. Thank you, everyone, for joining us. With me today is Peter Caldini, our Chief Executive Officer, and Sandra Harris, our Chief Financial Officer. Following our prepared remarks, we'll take your questions. Before we begin, I would like to remind you that comments made by management during this call will include forward-looking statements within the meaning of federal securities laws. These include statements on Establishment Labs's financial outlook and the company's plans and timing for product development and sales. These forward-looking statements are based on management's current expectations and involve risks and uncertainties.
For a discussion of the principal risk factors and
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