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Establishment Labs Holdings Inc.

ESTA · Healthcare · $2.0B mkt cap · FY2025 filings · · Shallow moat ·

Doesn't clear the bar

Shallow moat
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The five investor questions

65

2021–2025 (latest 5 aligned FYs; v3 window cap 5): revenue $127M to $211M, increasing; diluted EPS -1.72 to -1.72, flat.

94

Median gross margin 64.8% over 9y, stable.

0

Median ROIC -30.9%, above the 12% hurdle in 0% of years.

28

Net debt/EBITDA n/ax, interest coverage -2x.

24

Owner earnings changed trend unclear over up to the ten most recent annual observations.

Price vs. value if growth stopped today

A cautious baseline, not a price target: what the shares may support if normalized owner earnings simply hold steady.

Above value if growth stopped todayBelow value if growth stopped today
No price data
Not reported
Unavailable — insufficient owner-earnings data
Unavailable — insufficient growth-model data
$69.30
No price data

This zero-growth estimate assumes trailing owner earnings persist — unreliable for declining businesses. The recent FY revenue series does not trigger the three-consecutive-declines flag.

Among the current top-score group, the median current price is 227% above the zero-growth estimate across 49 of the current top 50 companies by Moat Score with both values.

Score records captured Sep 19, 2026.

Exactly which 50 companies?

FTNT, IBEX, META, MEDP, MSFT, GOOG, LULU, ANF, IDXX, TXRH, FHI, QLYS, FFIV, ADBE, LLY, MANH, VEEV, RMD, GRMN, PCTY, EAT, UI, SSD, MNST, DOCS, LRCX, MCO, CPRT, NTAP, NVDA, CORT, SFM, MPTI, ULTA, SN, ROL, CTAS, PAYC, IRMD, DECK, MORN, INTU, JKHY, TPR, LGCY, DAL, GWW, ISRG, MPWR, LOPE

Missing a usable price or zero-growth estimate: ANF.

Model details under moat-index@3.0.0: zero-growth multiple 11.1×, capped-growth comparison at no more than 18×; 9% discount rate; high-end growth 0% (capped at 4%) using min(5y revenue CAGR, 5y diluted-EPS CAGR), clamped to 0%–4%; maintenance capex uses min(capex, D&A); abstain when D&A is unavailable. This is a disclosed model range, not intrinsic value as fact.

10 years of fundamentals

The business, in plain English

Establishment Labs Holdings Inc. booked $211M of revenue in FY2025 in the Healthcare sector and kept 69.3% of it as gross profit — a high-margin business by that measure. After every other cost, −24.2% of each revenue dollar reached the bottom line.

Across the filed record, revenue grew from $34.7M (FY2017) to $211M (FY2025) — about 25.3% a year compounded over 8 years.

It earned −15.8% on invested capital in the latest filed year, FY2025. Across the full 6-year measurable filed record, median ROIC was −30.9%. Over the v3 recent window (6 measurable filed years), median ROIC was −30.9%. The Returns on Capital filter above scores it 0/100.

The balance sheet carried $248M of total debt in FY2025. Balance-Sheet Safety scores it 28/100.

Put together: Pricing Power is the strongest of the five filters (94/100) and Returns on Capital the weakest (0/100), which is how ESTA lands at 42/100 — a Shallow moat.

This breakdown is generated from the filed numbers and sub-scores above — no outside narrative, no estimates. Where a filing doesn’t disclose an input, the sentence that would need it is omitted instead of guessed.

FY2016–FY2025 · 10 fiscal years, normalized from ESTA’s SEC filings

Sales, as filed$211M FY2025
$0$100M$200M2016201920222025
Revenue kept after cost of goods69.3% FY2025
0%25%50%2016201920222025
Standard ROIC or separately labeled Operating ROICStandard ROIC −18.2% FY2025

Exact FY and FY-1 financing invested-capital inputs are required.

−40%−20%0%2016201920222025
Cash an owner could take out−$50.9M FY2025
−$50M$02016201920222025

The explained ROIC gaps have filed inputs but no meaningful positive invested-capital denominator. Other gaps mean the item is not in the filings for that year. The series is never interpolated or estimated. The Table view lists every filed value, including operating and net margins, total debt, and share count.

Flagship explainer

How Establishment Labs Holdings Inc. makes its money

Start with a dollar of revenue and follow what the filing says remains.

revenueBranching filed flows with values and percentages directly labeled. Missing filing concepts are omitted rather than estimated.Revenue$211M · 100%Cost of revenue$64.8M · 31%Gross profit$146M · 69%Operating income−$39M · −18%Income before tax−$58M · −27%Income tax−$7M · −3%Net income−$51.1M · −24%As of 2025-12-31 · 1 SEC filing sourceBuy Like Buffett · buylikebuffett.com

Honest partial: the filing did not provide a normalized tag for Research and development, Selling, general and administrative; those components are omitted, not plugged.

Table alternative
Filed lineValue% of revenueSource
$211M100%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Cost of revenue$64.8M31%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
$146M69%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
−$39M−18%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Income before tax−$58M−27%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Income tax−$7M−3%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
−$51.1M−24%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Source:
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
· event Dec 31, 2025 · retrieved Sep 19, 2026 · annual-row source set
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Flagship explainer

What Establishment Labs Holdings Inc. owns — and owes

Establishment Labs Holdings Inc.'s filing tags don't support a full breakdown — here's what is filed:

Table alternative
Filed lineValue% of assetsSource
Total assets$357M100%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Cash and equivalents$75.6M21%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
$248M69%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Stockholders’ equity$23.5M7%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Source:
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
· event Dec 31, 2025 · retrieved Sep 19, 2026 · annual-row source set

Flagship explainer

What drives Establishment Labs Holdings Inc.’s return on equity?

ROE is five filed business factors multiplied together.

DuPont return on equity factor treeReturn on equity branches into tax burden, interest burden, operating margin, asset turnover, and the equity multiplier.Return on equity−133%Tax burden88%net income ÷ pretax incomeInterest burden149%pretax ÷ operating incomeOperating margin−18%operating income ÷ revenueAsset turnover0.60×revenue ÷ average assetsEquity multiplier9.19×average assets ÷ average equityAs of 2025-12-31 · 1 SEC filing sourceBuy Like Buffett · buylikebuffett.com
DuPont source inputs
InputValueFiscal yearSource
−$51.1MFY2025
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Income before tax−$58MFY2025
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Operating income−$39MFY2025
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
$211MFY2025
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Ending assets$357MFY2025
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Beginning assets$347MFY2024
  • 10-K · FY 2024Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
$23.5MFY2025
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
$53.1MFY2024
  • 10-K · FY 2024Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Source: · event Dec 31, 2025 · retrieved Sep 19, 2026 · annual-row source set
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Flagship explainer

Where Establishment Labs Holdings Inc.'s cash went

Establishment Labs Holdings Inc.’s filing does not supply enough provenance-matched cash-flow lines for a truthful flow chart — here’s what is filed:

Table alternative
Filed lineValue% of cash from operationsSource
Cash from operations−$50.9M−100%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Depreciation and amortization$6.2M12%
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
Source:
  • 10-K · FY 2025Filing detailsAccession 0001688757-26-000022 · filed Feb 27, 2026
· event Dec 31, 2025 · retrieved Sep 19, 2026 · annual-row source set

Curated 19-manager tier

Who reported holding Establishment Labs Holdings Inc.

Delayed public 13F reports for 2026-Q2—not live positions, trades, or recommendations.

1 holding0 exited17 not holding18/19 resolved1 not retrieved

Named manager positions and quarter-over-quarter changes
ManagerReported positionQuarter-over-quarterFiling accession
Polen Capital22,541 shares$1.9M · 0% of eligible reported 13FTrimmed · -1,783 shares (−7%)
Abrams CapitalNo position reportedNo position reported
Akre CapitalNo position reportedNo position reported
Baupost GroupNo position reportedNo position reported
Berkshire HathawayNo position reportedNo position reported
Brave Warrior AdvisorsNo position reportedNo position reported
Dodge & CoxNo position reportedNo position reported
First EagleNo position reportedNo position reported
FundsmithNo position reportedNo position reported
Gardner Russo & QuinnNo position reportedNo position reported
Gates Foundation TrustNo position reportedNo position reported
Mairs & PowerNo position reportedNo position reported
Markel / Markel-GaynerNo position reportedNo position reported
Oakmark / Harris AssociatesNo position reportedNo position reported
Sequoia / Ruane CunniffNo position reportedNo position reported
Southeastern Asset ManagementNo position reportedNo position reported
Tweedy, BrowneNo position reportedNo position reported
Yacktman Asset ManagementNo position reportedNo position reported
Pershing SquareNot retrievedComparison not retrievedFiling not retrieved

Position size uses shares and filed value from each manager’s 13F. Portfolio weight uses the eligible long-share filing denominator. Changes compare only with the immediately preceding calendar quarter.

Source:
37 SEC filings
  1. 13F-HR · Q1 2026Filing detailsAccession 0000813917-26-000038 · filed May 15, 2026
  2. 13F-HR · Q2 2026Filing detailsAccession 0000813917-26-000042 · filed Aug 14, 2026
  3. 13F-HR · Q1 2026Filing detailsAccession 0000860643-26-000003 · filed May 13, 2026
  4. 13F-HR · Q2 2026Filing detailsAccession 0000860643-26-000005 · filed Aug 13, 2026
  5. 13F-HR · Q1 2026Filing detailsAccession 0000905567-26-000002 · filed May 1, 2026
  6. 13F-HR · Q2 2026Filing detailsAccession 0000905567-26-000003 · filed Aug 11, 2026
  7. 13F-HR · Q1 2026Filing detailsAccession 0000919574-26-003132 · filed May 15, 2026
  8. 13F-HR · Q2 2026Filing detailsAccession 0000919574-26-005176 · filed Aug 14, 2026
  9. 13F-HR · Q1 2026Filing detailsAccession 0001061768-26-000007 · filed May 14, 2026
  10. 13F-HR · Q2 2026Filing detailsAccession 0001061768-26-000010 · filed Aug 13, 2026
  11. 13F-HR · Q1 2026Filing detailsAccession 0001096343-26-000044 · filed May 1, 2026
  12. 13F-HR · Q2 2026Filing detailsAccession 0001096343-26-000065 · filed Jul 31, 2026
  13. 13F-HR · Q1 2026Filing detailsAccession 0001104659-26-062592 · filed May 15, 2026
  14. 13F-HR · Q2 2026Filing detailsAccession 0001104659-26-097175 · filed Aug 14, 2026
  15. 13F-HR · Q1 2026Filing detailsAccession 0001112520-26-000009 · filed May 14, 2026
  16. 13F-HR · Q2 2026Filing detailsAccession 0001112520-26-000014 · filed Aug 14, 2026
  17. 13F-HR · Q1 2026Filing detailsAccession 0001172661-26-001819 · filed May 14, 2026
  18. 13F-HR · Q1 2026Filing detailsAccession 0001172661-26-001911 · filed May 14, 2026
  19. 13F-HR · Q1 2026Filing detailsAccession 0001172661-26-001966 · filed May 14, 2026
  20. 13F-HR · Q1 2026Filing detailsAccession 0001172661-26-002294 · filed May 15, 2026
  21. 13F-HR · Q2 2026Filing detailsAccession 0001172661-26-003035 · filed Aug 4, 2026
  22. 13F-HR · Q2 2026Filing detailsAccession 0001172661-26-003402 · filed Aug 13, 2026
  23. 13F-HR · Q2 2026Filing detailsAccession 0001172661-26-003496 · filed Aug 14, 2026
  24. 13F-HR · Q2 2026Filing detailsAccession 0001172661-26-003728 · filed Aug 14, 2026
  25. 13F-HR · Q1 2026Filing detailsAccession 0001193125-26-208439 · filed May 6, 2026
  26. 13F-HR · Q1 2026Filing detailsAccession 0001193125-26-223352 · filed May 14, 2026
  27. 13F-HR · Q1 2026Filing detailsAccession 0001193125-26-226661 · filed May 15, 2026
  28. 13F-HR · Q2 2026Filing detailsAccession 0001193125-26-340443 · filed Aug 7, 2026
  29. 13F-HR · Q2 2026Filing detailsAccession 0001193125-26-349535 · filed Aug 13, 2026
  30. 13F-HR · Q2 2026Filing detailsAccession 0001193125-26-352200 · filed Aug 14, 2026
  31. 13F-HR/A · Q1 2026 · Amendment RESTATEMENTFiling detailsAccession 0001325447-26-000018 · filed May 14, 2026
  32. 13F-HR · Q2 2026Filing detailsAccession 0001325447-26-000020 · filed Aug 5, 2026
  33. 13F-HR/A · Q2 2026 · Amendment NEW HOLDINGSFiling detailsAccession 0001325447-26-000033 · filed Aug 24, 2026
  34. 13F-HR · Q1 2026Filing detailsAccession 0001398344-26-009296 · filed May 15, 2026
  35. 13F-HR · Q2 2026Filing detailsAccession 0001398344-26-014641 · filed Aug 14, 2026
  36. 13F-HR · Q1 2026Filing detailsAccession 0001569205-26-000005 · filed May 15, 2026
  37. 13F-HR · Q2 2026Filing detailsAccession 0001569205-26-000012 · filed Aug 14, 2026
· event Jun 30, 2026 · retrieved Sep 19, 2026

Flagship explainer

What Establishment Labs Holdings Inc. insiders reported

We could not retrieve insider activity for this rendering; no zero-activity claim is shown.

Unavailable: Form 4 activity could not be retrieved for this rendering.

Moat Score history

19 logged readings since Jul 17, 2026 · append-only, never rewritten

Moat Score over timeLast scored reading of each day, on the 0–100 scale42.0 / 100
0406080100WideNarrowShallowNo moatJul 17, 2026Sep 19, 2026

Breaks in the line mark methodology or normalizer upgrades — readings across versions aren’t compared, so a level shift there isn’t a change in the business.

Tier changesSame-methodology and same-normalizer crossings of the Wide / Narrow / Shallow bars

  1. Normalizer upgraded unstamped (version unknown)moat-xbrl-normalizer@1.1.0 — readings across versions aren’t comparedJul 26, 2026
  2. Methodology upgraded moat-index@2.0.0moat-index@3.0.0 — readings across versions aren’t comparedJul 23, 2026
  3. Methodology upgraded moat-index@1.2.0moat-index@2.0.0 — readings across versions aren’t comparedJul 20, 2026

Scores are logged append-only and never overwritten — this record cannot be reconstructed retroactively, which is exactly why it’s worth keeping.

Insider activity

Form 4 reports mix P/S market or private transactions with compensation-plan mechanics. Activity casually described as “insider selling” can include compensation mechanics; awards, tax withholding, and option exercises are shown by their exact filed class here, never collapsed into “Bought” or “Sold.”

These are disclosed filing facts and arithmetic aggregates, not a signal or verdict.

The insider-filing service is temporarily unavailable, so no partial or guessed answer is shown for ESTA.

Track record

How Establishment Labs Holdings Inc.’s moat rated in each of the years we can reconstruct from its filings — scored only on what was knowable at the time — and what its price and returns did afterward. The score never saw a price; the two are joined only in hindsight, for education, not as a signal.

Point-in-time scores 2018–2025, one methodology version · reconstructed from filings on file each Dec 31 — never with hindsight

Point-in-time Moat Score (dot colored by tier)Indexed price (total-return (dividends reinvested))Rated Wide-moat that year

How to read this: each dot is what the engine would have scored ESTA on that December 31; the line below is its total-return price path (dividends reinvested) in the years since.

0406080100WideNarrowShallowNo moatPoint-in-time Moat Score100200Indexed price · log scale (2019 = 100)20182020202220242026

Two tracks, one timeline: the score has its own 0–100 scale (top), the price its own 100-based scale (bottom) — never a shared axis. The price path is a total-return (dividends reinvested) index built from the same data the forward returns use; gaps in the score line are years with no reconstructed rating (see the table for why). The Table view carries every value.

What followed, in the years it rated Wide

In the reconstructed history shown, ESTA did not rate Wide-moat in any year, so there is no wide-moat track record to report. That absence is itself the honest answer — we don’t manufacture a comparison where the rating never earned one.

Healthcare context

#310 of 709 scored Healthcare companies, ranked by Moat Score.

Nearest peers by Moat Score

  1. #308SRTS Sensus Healthcare, Inc.42.0Shallow moat
  2. #309ZEOX Zeo ScientifiX, Inc.42.0Shallow moat
  3. #311CLDX Celldex Therapeutics, Inc.41.9Shallow moat
  4. #312AXGN Axogen, Inc.41.9Shallow moat

Compare ESTA with its nearest peers →All Healthcare companies on the Index →

Common questions about ESTA

Does Establishment Labs Holdings Inc. have an economic moat?
Based on its FY2025 SEC filings, the Moat Index scores Establishment Labs Holdings Inc. (ESTA) 42.0 out of 100 — a Shallow moat. The five questions behind that score begin at 20% each; if exactly one genuinely lacks data, the other four weights are renormalized and disclosed. revenue and EPS trend 65, pricing power 94, returns on capital 0, balance-sheet safety 28, capital allocation 24.
How has ESTA's Moat Score changed over time?
The record logs 19 readings since Jul 17, 2026; the latest reads 42.0 out of 100 (shallow moat). No tier changes on record yet. (Methodology or normalizer upgrades on Jul 20, 2026, Jul 23, 2026, Jul 26, 2026 re-based the score; readings across versions aren't compared.) The history is append-only — readings are only ever added, never rewritten.

Scored from primary SEC filings via the public methodology. Educational only — not a recommendation to buy or sell ESTA. See the disclaimer.