Establishment Labs Posts Fourth Straight Positive EBITDA Quarter
The breast-implant maker raised its full-year revenue guidance to $269-271 million after second-quarter sales climbed 31.7% and its operating loss narrowed by roughly 70%.
Establishment Labs Holdings (ESTA), the maker of Motiva breast implants, reported second-quarter revenue of $67.5 million, up 31.7% from $51.3 million a year earlier and up 12.8% sequentially from $59.9 million in the first quarter. The company raised its full-year 2026 revenue guidance to $269-271 million, the second increase this year after a prior guide of $266.5-268.5 million set in the first quarter, which itself had been lifted from $264-266 million at year-end 2025.
The quarter extended a run of improving profitability that has now stretched across four consecutive periods. Adjusted EBITDA came in at a positive $3.7 million, compared with a loss of $8.5 million in the same quarter last year, following positive readings of $1.2 million in the first quarter and $5.5 million in the fourth quarter of 2025. The operating loss narrowed to $4.3 million from $14.1 million a year earlier, a reduction of about 70%, while net loss fell to $11.7 million from $16.6 million.
Growth in the U.S. market drove much of the improvement. Motiva USA revenue reached $24.7 million, up 26% sequentially from $19.6 million in the first quarter and more than double the $10.3 million posted in the second quarter of 2025. That marked a third straight quarter of accelerating U.S. sequential growth, following a 13.3% sequential gain in the fourth quarter of 2025. Establishment Labs' minimally invasive platform also picked up pace, generating $12.1 million in revenue versus $9.1 million in the first quarter, after the company raised its full-year target for that line to more than $35 million from an earlier $30 million guide.
Gross margin expanded to 70.6% from 68.8% a year earlier, continuing a trend evident in the prior two quarters, when margins rose to 70.7% from 67.2% and to 70.5% from 68.5%, respectively. Adjusted operating expenses, which exclude one-time charges, rose just 2.0% year over year against 31.7% revenue growth, an improvement in operating leverage from the first quarter's 8.9% expense growth against 44.7% revenue growth.
The quarter's expenses included $2.2 million in one-time debt refinancing and restructuring charges, up from $0.5 million a year earlier, tied to a credit refinancing with Oaktree completed during the period. Establishment Labs borrowed $265.0 million under the new facility, repaid $246.4 million of prior debt and incurred $10.0 million in financing fees; the EBITDA reconciliation now separately breaks out $1.857 million in third-party refinancing costs alongside $321,000 of restructuring charges. Cash rose to $71.2 million at quarter-end, up $3.1 million from $68.1 million in the first quarter, reversing a sequential decline that had taken the balance down from $75.6 million at the end of 2025.
Establishment Labs also added to its board, naming Taylor Harris, the former Cutera chief executive and MyoKardia chief financial officer, as a director on June 29. The second-quarter release quoted only Chief Executive Peter Caldini, a departure from the first-quarter release, which had included commentary from Chief Financial Officer Sandra Harris on the Oaktree refinancing and an expectation of positive free cash flow in the second half of the year.