Establishment Labs Holdings Inc (ESTA) 2025 Q3 法說會逐字稿

Good afternoon. Welcome to Establishment Labs 3rd quarter 2025 earnings call. At this time, all participants are in a listen-only mode. At the end of this call, we will open the line for a question-and-answer session, and instructions will follow at that time. As a reminder, today's call is being recorded.

I will now turn the call over to Roger Denhoy, Chief Financial Officer. Please go ahead, sir.

Thank you, operator, and thank you, Irvin for joining us. With me today is Peter Caldini, our Chief Executive Officer. Following our prepared remarks, we'll take your questions.

Before we begin, I would like to remind you the comments made by management during this call will include forward-looking statements within the meaning of federal securities laws.

These include statements on Establishment Lab'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 uncertainties that may affect our performance or cause actual results to differ materially from these statements, I encourage you to review our most recent annual and quarterly reports on Form 10k and Form 10Q, as well as other SEC filings which are available on our website at establishmentlabs.com.

I'd also like to remind you that our comments may include certain non-GAAP financial measures with respect to our performance, including but not limited to sales results, which can be stated on a constant currency basis or EBITDA, which we disclose on an adjusted EBITDA basis.

Reconciliations to comparable GAAP financial measures for non-GAAP measures, if available, may be found in today's press release, which is available on our website.

The content of this conference call contains time sensitive information accurate only as of the date of this live broadcast, November 5th, 2025, except as required by law established the labs undertakes no obligation to revise or otherwise update any statement to reflect events or circumstances after the date of this call. With that, it is my pleasure to turn the call over to Peter.

Good morning to everyone and thank you for joining today. Q3 2025 was a standout quarter for Establishment Labs.

We grew global revenue 34% with the total revenue of 53.8 million, including $11.9 million in the US.

We also exceeded 70% gross profit margin for the first time, coming in at 70.1%, and we achieved the first quarter of positive EBITDA in our company's history with 1.2 million in Q3.

Getting the positive EBITDA ahead of the 4th quarter was an important goal for our company, and we now turn our focus towards reaching cash flow positive next year.

While optimizing our business, we had meaningful revenue growth in the US and our other direct markets.

I'd like to thank all the employees that made this a priority and a reality, and the sense of accomplishment has all our employees eager for a next milestone of cash flow positive.

The US business is our most important growth segment right now, and it continues to outperform.

Q3 revenue was $11.9 million up 16% sequentially in what is a seasonally slower quarter in breast procedures.

Markets can be down 20% to 30% sequentially in Q3, making our results all the more impressive.

For the first three quarters, US revenue totaled $28.3 million so we are clearly going to do quite a bit better than the $40 million we committed to last quarter.

We are expecting considerable acceleration of the US business in Q4, and we are already seeing a significant shift from Q3, but as it's our first full Q4, we are going to be prudent by raising our 2025 revenue guidance to exceed 210 million, where we previously had a range of 208 to 212 million.

Most interesting is what these results imply for 2026, because we should finish 2025 at an approximate 20% share in US breast augmentation market, and the momentum has not slowed.

While 2026 will be a continuation of our growth in the breast augmentation segment, we are looking forward to our approval in breast reconstruction, which is a similar in market size to augmentation, and we are preparing for the US launch in this segment.

Outside the US, we saw good growth and remain on track for single-digit growth this year.

Accelerating growth in our direct markets has been a priority, and we are seeing the benefits of the changes we have implemented.

Excluding the benefit of currency and the acquisition of our Benelux distributor, our European direct market sales increased approximately 20% this quarter over Q3 2024.

In our distributor markets, Asia Pack had a strong rebound from the second quarter as the ordering cadence normalized.

Our US business is performing at a very high level. The number of surgeons using Motiva continues to increase. We now have over 1,300 surgeons using Motiva, including some of the highest volume and best known practices in the country, and we are attracting additional waves of adopters as the benefits of Motiva in both clinical and commercial practice resonate.

We are as focused on surgeons making Motiva their primary implant of choice as we are at attracting new surgeons to our business.

We continue to bring groups of surgeons down to Costa Rica for training and surgery. Over 50 surgeons attended our September and October classes, and more than 250 surgeons have come to Costa Rica since launch.

We are expecting a similar pace in 2026 with seven sessions already scheduled. There is no shortage of surgeons that want to make the trip.

Surgeons learn about the science behind our implant technology, see the best in class standards employed throughout our facilities, and experience our commitment to driving innovation in the category, including discussing and offering input to our R&D pipeline.

While some surgeons come already enthused about establishment labs, almost every surgeon returns to their practice as a fan of our company.

Social media continues to play an important role as plastic surgeons advocate motiva to their audiences.

Plastic surgeons consistently tell us that if they offer patients a choice between Motiva and legacy implants, it's almost unanimous that patients will choose Motiva.

This puts us in a position of strength, and we win if we convince plastic surgeons to give patients a choice.

Every legacy brand has a much more challenging proposition.

They have to convince plastic surgeons to offer only their products.

Championing women's health and advocating for patients' choice should accelerate us to take a majority of the US market over the next several years.

In Q3, we conducted a survey of surgeons that are early adopters and advocates of Motiva to understand the impact of motiva on their practices.

While industry sources point to a market that has not experienced much growth, the practices offering Motive in our survey increased their procedures by 14.6% so far this year.

Surgeons tell us that patients are coming in and asking for Motiva by name, and we hear from surgeons as well that many women are entering the category because of Motiva.

We regularly hear that women are abandoning their warranty of their legacy implants and choosing to pay out of pocket for Motiva.

As many of this is incredibly rare in healthcare.

But it's happening now as our entry is changing the industry.

There isn't just one single reason for this. Some women cite the improved safety profile offered by Motiva, and others cite the benefits of having an above the muscle procedure without compromise. And yet for others, it's the increased awareness from our marketing efforts.

Whatever the reason, it's clear the conversation around breast augmentation is changing.

This is a powerful combination.

We are not only capturing share, but we are expanding and accelerating the market for breast augmentation.

A major driver for market expansion is our minimally invasive portfolio.

As we have noted, we trained a group of US plastic surgeons in July as part of our early experience group for preserve aid to gain insights prior to going to market more broadly.

Preserve is a breast tissue preserving procedure that can be done without the need for general anesthesia, offering smaller scars and fast recovery.

Preserve can be used in a wide cross section of cases surgeons see in their day to day practices.

As these surgeons have taken Preservv back to their practices and started to perform procedures.

The feedback has been very positive, not only from surgeons, but also from the women who have received the procedures. I encourage you to seek out the videos and testimonials that have been posted on our social media to see the early responses.

Surgeons have embraced the fundamental changes Preserve brings to breast augmentation. It is not just a new way to do an existing procedure. It is an entirely new concept in how a breast procedure can be done.

Preserve has the potential to drive category growth and improve the economics for surgeons. We are seeing as much as a 40% price premium to a standard breast augmentation for these early experienced surgeons.

The group of surgeons that came for preserve training were each supplied a small number of kits in August.

A majority of the kits we provided have been used, and surgeons consistently ask us for more to alleviate growing wait list.

From just our early experience launch, we would estimate that 300 present day cases have been performed in the US and there are at least 100 women on waitlists around the country.

Not expectedly, there is a groundswell of surgeons that have asked to be trained on Preserve, and we will begin these trainings in January. We have 2 such trainings planned for the first quarter alone and would expect a similar cadence throughout the year.

In breast reconstruction, our floor tissue expander is now in use at over 150 hospitals in the United States.

This bodes well for expected launch into the reconstruction, and we remain on track to file our PMA supplement by the end of the year.

We also remain on track for the approval of our small sizes in the US in early 2026, and this should help accelerate growth both with new doctors as well as increasing the usage of our current doctors.

Outside the US, excluding the benefit of Benelux acquisition and currency, direct markets globally grew 15% versus last year.

We believe this performance is well above the underlying market growth rates in these regions.

In our Latin American direct markets, we continue to see stabilization in Brazil and strong growth in Argentina.

European direct markets are being led by strong performances across the continent with standouts in the UK and Spain.

The number of accounts in many of our direct countries continues to increase, a positive sign and a reflection of the increased focus on performance in direct markets.

We are taking advantage of our strong growth in direct markets to make sure that the O US business as a whole is primed for growth.

We are engaging with our distributor partners regularly. We are working to raise standards globally around payment terms, inventory forecasts, and market share expectations.

In our minimally invasive portfolio, Mia remains on track to achieve $8 million to $10 million in revenue in 2025, and Preserve continues to see good adoption in international markets.

Surgeons globally are seeing the benefits of breast tissue preservation made possible by our minimally invasive platform.

The successful rollout of Preserve and the continued growth of Mia has resulted in above market growth and proves its potential for market expansion.

Globally, we expect the portfolio of Mia and Preserve will exceed 30 million in 2026. I will now turn the call over to Raj.

Thank you, Peter.

Total revenue for the third quarter was $53.8 million an increase of 33.7% from last year. Excluding the positive impact of foreign exchange in the quarter, growth would have been approximately 31.4%. Sales for Motif in the United States were $11.9 million.

On a geographic basis, sales in Europe, Middle East, and Africa were 35.6% of the global total. We saw strong sales in our direct markets in the region while sales to distributors were lower on the timing of orders.

Sales in the United States were 22.1% of the global total.

Latin America was 21.7% of sales. Brazil remained stable, and we saw strong growth in our other direct market in the region, Argentina, as well as from our distributors.

Asian Pacific was 20.6% of sales. Results in the quarter rebounded sharply from last quarter as expected orders from our distributors were realized. Sequential growth in the region was 46%.

Our gross profit for the third quarter was $37.7 million or 70.1% of revenue, a 620 basis point increase compared to 63.9% of revenue last year and 130 basis points higher than the 68.8% in the second quarter of this year.

This is the first time we've crossed 70% gross margin.

And the increase is primarily the result of the higher margin sales in the United States. We expect gross margins in 2025 will be approximately 300 basis points higher than in 2024.

As it relates to tariffs, goods imported from Costa Rica to the United States are subject to duties. However, as we saw in 3Q, we are managing their impact and do not meaningfully change our trajectory for gross margin improvements this year.

SG&A expenses of $37.2 million were approximately $3.1 million higher than the third quarter of 2024.

R&D expenses for the third quarter were $4.6 million.

Total operating expenses for the third quarter increased approximately $2.9 million from the year ago period to $41.7 million.

Property expenses have been approximately $45 to $46 million on average per quarter, which is what we guided to at the start of the year and what we continue to expect.

As we saw in this quarter and in the second quarter, there can be fluctuations based on the timing of expenses.

Adjusted EBITDA was positive $1.2 million in the third quarter. This compared to a loss of $8.5 million in the second quarter and $12.1 million in the first quarter. This is our first EBITDA positive quarter as a company, and there are a couple of things to highlight.

While the improving results are being supported by the strong sales and the higher gross profit in the United States, we've been very focused on managing our operating expenses.

While operating expenses in the third quarter increased approximately $3 million from a year ago, they were down over $5 million from the third quarter of 2023.

Over the time we invested significantly in our US commercial operation and launched our minimally invasive portfolio.

We were able to do this by finding efficiencies across all parts of the organization and making structural changes where needed.

We expect EBITDA will continue to improve, including in the 4th quarter, and expect to remain EBITDA positive from here on.

For 2026, we will continue to expand our commercial infrastructure in the United States. However, the investments we make overall as a company will be at a rate well below expected top-line growth.

We've been investing with the expectation of global market leadership and have built an organization that can take full financial and commercial advantage as that occurs.

Most of our spending in this regard has already happened.

For example, the facilities we have today can produce more than 50% of the world's implants.

We expect revenue to grow more than 20% for at least several more years, and our business should start to show meaningful and increasing earnings in 2027 and beyond.

Cash increased $16 million in the third quarter to $70.6 million from $54.6 million at the end of the second quarter.

The increase was primarily the result of drawing the remaining 25 million tranche of our credit facility offset by our operating cashes.

If Sweden net proceeds, cash use would have been $8.5 million in the third quarter.

This compares to $14.5 million in the second quarter and $21.2 million in the first quarter.

We expect cash use to improve further in the 4th quarter and expect to reach cash flow positive in 2026 without the need for any further equity raises.

Her credit facility within the last year of its term in April. We are considering a number of refinancing financing options that could further reduce our cash use.

We're also working to make ESTA eligible for inclusion in a number of indices, most notably the Russell. There are a number of things we can do to affect this, and we believe we will be eligible for future rebalancing's.

As Peter noted, we now expect our revenue in 2025 will exceed $210 million in upward revisions from our previous guidance of $208 to $212 million. Our updated outlook represents growth of at least 26%.

The US remains a primary engine of growth this year. We have seen very strong results over the first three quarters of 2025, and this has continued into the 4th quarter.

Our direct markets outside the US are also doing well, and demand globally for our products remains good.

Gross margins are improving, and we are managing our operating expenses, which allowed us to achieve positive EBITD a quarter early.

We expect to see continued improvements in profitability and remain confident we'll reach cash flow positive in 2026.

I will now turn the call back to Peter.

The Third quarter of 2025 was in many ways a turning point for our company.

We achieved positive EBITDA for the first time, and we achieved this in a quarter where we grew revenue 34%.

These results show that we can efficiently invest in and grow our business, and we will continue to do so.

The next step is to achieve cash flow positive, which I am confident we will do next year.

We expect our top-line growth to remain above 20% for the next several years, and our profitability should expand at a much faster pace.

I am looking forward to having conversations with our shareholders about our increasing EPS and how we can keep that momentum going for the next 5 to 10 years.

Operator, we're ready to take questions.

Thank you. At this time, we will conduct a question-and-answer session. If you would like to ask a question, please press 1 on your telephone keypad. A confirmation tone will indicate your lines in the question queue. We ask that you ask one question and one follow-up. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the keys. Once again, that's one to ask a question at this time. One moment while we post for our first question.

The first question comes from Anthony Petrone with Mizuho Financial Group. Please proceed.

Thanks, and, congrats to the team all around here on strong execution.

Maybe Pete and Roger could start with, the comments on 2025 and just the implied outlook, as we head into the end of the year.

I'm just looking for some more, inputs, puts and takes on that 4Q number specifically. How should we think about US trends? Obviously there's strong momentum on the US side. But maybe a little bit more detail on what we're thinking about for new account openings from here, preserve uptake, and then lastly just the EBITDA positive, well ahead of expectations, how do you think about EBITDA, trending from here just given the momentum on the US side. Thanks again.

Yeah, thanks for the question, Anthony. Clearly a lot of momentum in the business heading into the 4th quarter, and this, as we noted, we're planning to exceed $210 million now, for the year. And as it relates to the 4th quarter, the US has quickly become our largest market, and we have a lot of momentum in the US. For us though, we haven't yet seen a 4th quarter, right, and there are some nuances in the fourth quarter around reconstruction and some of the holidays and things, and so we just want to be prudent in terms of, how we set the midpoint for the 4th quarter, but clearly we have a lot of momentum and we expect to meaningfully exceed the $40 million we previously provided. And so the US is doing very well. Outside the US, we also have a lot of momentum, specifically in direct markets where we're seeing very strong growth. In Europe we were north of 20%, in direct markets this quarter. We have a really strong order book for the 4th quarter from our distributors and so we're expecting a very strong finish to the year and I think importantly that sets us up really well for 2026, right? The momentum we're carrying in the business that will play for the next year really is a nice place to be as we're entering the new year, as it relates to EBITDA, again, we're all very proud of what we've achieved here a quarter early, the 1.2 million. But as we also noted, it's just the beginning here, right? We're, we have a lot of leverage we can still bring through this business as we're investing, and you'll see the doc continue to expand in the fourth quarter, and we expect to continue to show nice improvement overall in 2026. And so I think the business again has a lot of momentum. You're starting to see the profitability, the leverage in the model, and we expect that's going to continue from here forward.

Appreciate that. I'll hop back.

The next question comes from Josh Jennings with TD Kwan. Please proceed.

Hi, good morning, and, congratulations on arriving in the EBITDA positive era a little bit earlier than expected. Pete and Raj, what was hoping to just start on the thinking about 2026 and international business, but specifically China. Any updates just in terms of, the outlook there and, the distributor relationships and when reordering could start to kick in. We should we be expecting Q1 2026? Is there any chance that there could be some China orders in the fourth quarter?

Yeah, so, thank you, Josh, in terms of the, OUS markets, I think in general we've seen stabilization, for the most part across all the markets, our focus going into this year, Josh was really driving growth in our direct markets and I think we've been very successful in doing that. We have better economics, we have more upside potential in those markets and this. Raj mentioned, we had 20% growth, and that's following a quarter where we had 27% growth in our European markets, so we're gaining accounts, a lot of that growth is being fueled by preserve, but very strong performance, and we're going to continue to focus on that, going into 2026, and, we see good momentum in the, fourth quarter and that's just going to continue into, next year.

Yeah, as it relates to to China, I think, we're working very closely with our partners there we've actually seen some good progress, especially from a sellout standpoint, and we're going to continue to work closely with them and we're going to keep you updated, but we want to make sure we build the the business there the right way.

Thank you. The next question comes from Allen Gong with JPMorgan. Please proceed.

Thanks for the question. I have one on the broader market. When we looked at some of your peers and aesthetics, I think some of the body language we were getting from them was definitely a bit more cautious on market dynamics, especially heading into 4th quarter, looking at your results and listening to, your confidence, definitely sounds like you're not seeing that. So, I guess, are you not seeing that weakness, are you just growing through it, or is there a reason why those challenges are more company specific than for the broader market?

Yeah, thanks, we first I mean we can't really comment on their perspective in terms of the market. I can just tell you how we're seeing the market in the US specific to breast aesthetics, I think we've created a lot of momentum in the marketplace, and I think what we mentioned the prepared remarks in some of the accounts that have, early adopters and we see you, but we're seeing an increase. In the number of procedures, so what we are seeing as it relates to our business, we're seeing growth, we're very, positive in terms of the momentum we've been able to build in the Q4 and that's just going to continue into, next year.

The next question comes from SAM Eber with BTIG. Please proceed.

Hi, good morning. Thanks for taking the questions. Maybe I can shift over to the minimally invasive platforms you talked about the 30 million, in revenue for next year. Can you just maybe help frame contribution this year, if there's any way to parse out Mia versus Preserve, and then, what market development work needs to happen to get to those, the, at least 30 million target for next year. Thanks for taking the.

Questions. Yeah, thanks SAM. We, we're, I mean, we're very happy with the progress we're making with, Preserve and the minimally invasive platform, speaking specifically on you, we've doubled the number of accounts this year and that was our goal. And then with Preserve Day we're off to an outstanding start.

In Europe and we're really focusing primarily on the direct markets but we're also expanding it to some of our distributor markets.

And that momentum is is going to continue into 2026 we mentioned also that in the US, we're going to be launching early part of next year so we're we're looking at the end of the first quarter. There's already significant demand we've seen that with the early experienced surgeons. They're very excited and you know I think once it's launched, I think it's going to be a pretty quick ramp up so we're very pleased with that that platform and how it's performing.

The next question comes from Joanne Winch for Citibank. Please proceed.

Hi, good morning. This is, Anthony filling in for Joanne. Thanks for taking the question. Is there any chance you could provide either quantify or maybe provide a little bit more granularity around, your expectation for US sales to meaningfully exceed 40 million this year?

Yeah Anthony, as I TRY to answer the first question, right, the 4th quarter again is we have, we're carrying a lot of momentum into the 4th quarter, right? And so we'll, we will do, quite a bit better than the $40 million we've previously talked about. However, it is the first time we've had a 4th quarter in the United States, right? And so there is some holidays, some other elements to the quarter that make it difficult to kind of.

Tell you exactly where we're going to land, and so again it's a difficult question, but I think, the reality is we're doing very well in the US. The number of accounts, the orders we're getting, all of it is really pushing in the right direction, and we just, we simply have a lot of momentum that we're carrying right now.

The next question comes from Mason Krick with Stevens Capital Management. Please proceed.

Hey, thanks for taking the question.

So reiterating the the single-digit growth in international revenue, it seems like you're seeing strength across a handful of markets.

Stability and others are you willing to quantify how at least preliminarily you're thinking about growth in the international market next year?

Yeah, I think Mason, it's a, it's a good question, right? We haven't yet provided the 2026 outlook, but.

From a high level standpoint we're seeing very good demand in our direct markets. It's been an area of focus for us. We spent a lot of time, making sure we have the right team there, the right structure there, and you are seeing that play out now, and we don't expect that momentum will slow, and so that is going to carry us into 2026, the other part of the business is distributors. We don't have perfect visibility into how the distributed markets are doing, but generally the tone in those markets remains very good.

The end markets seem very similar to what we're seeing in our direct markets and so overall we're expecting in 2026 our international markets will perform well, and then you marry that with what we're seeing in the United States and we commented we expect to finish it at approximately 20%, which provides a very good stepping off point in the US for 2026 and overall we're expecting another Year of very strong growth for the company.

Got it. Okay. And in terms of motiva accounts in the US, what are you guys seeing in terms of trends among customers after adoption? How quickly are you seeing them ramp up? Is there a an average amount of their practice they end up converting just any incremental detail you can provide there?

Yeah, I think and, as we mentioned before, I mean, the growth in the US, is really exceeding all our expectations. We've kind of over delivered on most of the internal KPIs that we have, so we're very pleased with that. We continue to add additional accounts. The utilization rate continues to pick up, especially as a lot of the accounts are, going through their scheduling process.

What also helps quite a bit in terms of the utilization and also the penetration is the number of patients that are entering the the the accounts asking specifically for Otiva, so we're seeing a really good growth in the Q4 and it's somewhat of an inflection point for us and we believe that momentum will finish this year and then it's going to continue to grow next year, especially when you start laying over, some of the preserve launch also the small sizes as well.

Got it. Thank you.

The next question comes from Mike Matson with Needham and Company. Please proceed.

Yeah, thanks. So, I wanted to get some clarification on the commentary around getting to 20% share ex in the year. So we had estimated that the US market augmentation market's around 600 million, so about 150 million a quarter, if you flatline it, and 20% of that would sort of imply about 30 million. I mean, is that math reasonable, or am I missing something? Maybe you mean like as of the very last day of the quarter you'll be at, it's ramping through the quarter and you'll be at 20%, as of the very tail end of the quarter or something like that.

Yeah, like, I think, just a level set, I think your expectation for the size of the market may be a little bit off, if you look at some of the data from the clinical societies, the market in the United States is estimated at approximately 300,000 procedures a year. Our ASPs, as we've talked about, are, around $1300 a little north of 1,300 per case, that puts you at a little bit below $400 million for the augmentation market. The reconstruction market is a market.

About that same size, right? So if you just think about the augmentation market, you're looking at a market close to $390 million to $400 million in that range, and that is the market against which we expect to exit at about 20%.

Okay, so more like a $20 million dollar number then.

But again, that's also an exit rate right as we're leaving 2026.

Okay, alright, I understand, and then just, as far as the fourth quarter goes, how much visibility do you feel you have? I mean, we're over a month into the quarter now, I guess, sorry, two months into the quarter now, and then I know you have orders that you get, and so I don't know how much lead time there is between the order and a shipment and things like that, but.

Well, we do, I mean, we do see the daily orders, right? We know the number of customers we have, and so we have very, we have quite a bit of visibility in how the business is tracking and as we've noted, there's a lot of momentum right now. Those metrics all continue to go higher, and as we're leaving the 3rd quarter and we've entered the 4th quarter here, moving out of that seasonally slow period, there's a lot of acceleration in this business, again, it's our 1st 4th quarter as a company in the United States and so we just want to be prudent in terms of. Where we set the the midpoint of where we think we end up, but you shouldn't think that there's anything, behind that, right? The business is doing extremely well and we're going to have a very strong finish to the year.

Okay, I understand, thanks.

The next question comes from Matthew Taylor with Jeffries. Please.

Proceed. Hi, good morning. This is, Matt on for Matt Taylor. I just wanted to ask a quick question on 2026 and assuming you're exiting 2025 with around 20% market share.

Looking at your kind of strategy into next year, do you anticipate driving your expansion primarily through penetration with these existing accounts or is it mainly blocking and tackling going after new accounts?

Yeah, so I mean as we mentioned before, I mean we're exiting 2025 with tremendous momentum. We keep on adding existing accounts or adding accounts. The utilization rate continues to pick up.

And that momentum's going to continue into next year. Now what we're also doing is we, and we mentioned this on the on the previous call, we're going to be adding additional reps up to about 15 reps, for next year, and that will help increase the utilization also the reach, in some of those accounts that we can add into to next year.

We're also going to be launching, preserve at the end of the 1st quarter and then we also have the launch of the small sizes which we anticipate at the beginning of next year. So I think you're going to see a combination continued growth in the accounts that we are in, and, as we continue to increase the utilization rate, we're going to be adding additional accounts and then you also have with the expansion. In terms of, filling out our matrix as well as, with the preserv a launch I think you're going to see a combination of of both.

Okay, that's helpful. So I'd say like looking at your 5-year plan, you're still fairly confident and kind of reaching that.

Goal of, I don't know, 40% to 70% that you've seen in other markets.

Is that fair to assume? Yes, okay.

Thank you.

Thank you. This is all the time we have for questions today. I will now turn the call back over to Peter Caldini for closing remarks.

Okay, thank you everybody for joining look forward to the next call and, thank you very much for attending.

This concludes today's teleconference. You may disconnect your lines at this time.

Thank you for your participation and have a great day.