Establishment Labs (ESTA) Q2 2026 earnings summary

Executive summary

• Q2 2026 revenue reached $67.5 million, up 31.7% year-over-year, with adjusted EBITDA of $3.7 million, marking a turnaround from a loss last year.

• Revenue for the first half of 2026 increased 37.5% year-over-year to $127.4 million, driven by strong U.S. and international sales.

• U.S. revenue surged 140.9% to $24.7 million in Q2, now 36.6% of total revenue, fueled by Motiva adoption and Minimally Invasive platform growth.

• Gross margin improved to 70.6% in Q2 2026, up from 68.8% in Q2 2025, driven by higher-margin markets and favorable product mix.

• Cash and equivalents ended at $71.2 million as of June 30, 2026, up $16.5 million year-over-year.

Financial highlights

• Gross profit for Q2 2026 was $47.7 million (70.6% margin), up from $35.3 million (68.8% margin) in Q2 2025.

• Operating expenses for Q2 2026 totaled $52.0 million, with strong operating leverage and $2.2 million in one-time charges.

• Adjusted EBITDA improved by $12.2 million year-over-year, turning from a loss to a $3.7 million gain in Q2 2026.

• Net loss narrowed to $11.7 million in Q2 2026 from $16.6 million in Q2 2025; net loss per share was $(0.39).

• Interest expense increased to $7.0 million in Q2 2026 due to higher debt levels.

Outlook and guidance

• Full-year revenue guidance raised to $269–$271 million, with U.S. as primary growth driver and OUS business stable.

• Minimally Invasive platform expected to be about 15% of 2026 revenue.

• Free cash flow positive expected in H2 2026 and for full-year 2027.

• 2027 revenue growth projected around 25%.

• Management expects strong growth in the second half of 2026 and into 2027, with a focus on achieving free cash flow positivity.