Forensic Analysis · Healthcare / Pharmaceuticals / Biotech · as of Jun 27, 2026
ESTABLISHMENT LABS HOLDINGS INC. (ESTA)
A forensic read on ESTABLISHMENT LABS HOLDINGS INC. built from its complete SEC filings — financial-health screens, earnings quality, red flags and a price-aware rating. Reproducible math, not opinion.
D · Weak — demands caution
Forensic grade
Distress
Financial health
-2.1
Altman Z-score
Clean
Earnings quality
3
Forensic signals
-225.9%
ROE
$2.6B
Market cap
ESTABLISHMENT LABS HOLDINGS INC. earns a D (Weak — demands caution) forensic quality grade, and its Altman Z-score is -2.1, placing it in the Distress zone. 3 forensic signals were flagged in its latest SEC filings, led by return on invested capital.
What the filings flag
-15%Return on invested capital.Return on invested capital is -15% and rising from -30% — well below its ~10% cost of capital, so reinvested dollars may be destroying value, not building it.
+7.0%/yrShare-count dilution.Diluted share count changed +21% over the last 3 years to FY2025 (+7.0%/yr). The count is GROWING — existing holders are being diluted. That's ~7.0% shaved off per-share growth every year — total profit has to grow that much just to keep earnings-per-share flat, and a stake held since FY2022 has been diluted ~21%.
+11.9%Accruals ratio.Net operating assets grew +11.9% relative to their average in FY2025 — the accrual component of earnings. Accruals are building faster than is comfortable — part of profit sits in receivables, inventory or capitalized costs rather than cash. The cash-flow cross-check agrees: reported earnings ran in line with operating cash by -0% of net operating assets.
Key fundamentals
Net Margin-24.2%
Debt / Equity10.94x
Free Cash Flow$-56.9M
Latest Revenue$211.1M
Return on Equity-216.9%
Revenue Growth YoY+27.1%
Go deeper — free with an account
The forensic grade and screens above are free — no account needed. An account adds the full interactive deep-dive on ESTABLISHMENT LABS HOLDINGS INC.:
🔒The written investment read — what the numbers mean, in plain English
🔒Ask anything about ESTA's filings — AI Q&A across the 10-K, 10-Qs & 8-Ks
🔒Interactive valuation — reverse-DCF sliders, Monte Carlo & scenario stress
🔒Calibrated 12-month price forecast, with the math shown