Establishment Labs Holdings Inc (ESTA) 2025 Q4 法說會逐字稿

Good afternoon. Welcome to the Establishment Lab's 4th quarter 2025 earnings call. At this time, our participants will be in a listen-only mode. At the end of the call, we will open the line for question-and-answer session, and instructions will follow at that time.

午安.歡迎參加 Establishment Lab 2025 年第四季財報電話會議。此時，我們的參與者將處於只聽模式。通話結束時，我們將開放問答環節，屆時將給予相關說明。

As a reminder, today's call is being recorded. I will now turn the call over to Raj Denhoy, Chief Financial Officer. Please go ahead, sir.

再次提醒，今天的通話將會被錄音。現在我將把電話轉交給財務長 Raj Denhoy。請繼續，先生。

Thank you, operator, and thank you everyone 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 meeting of federal securities laws. These include statements on establishing lab's financial outlook and the company's plans and timing for product development and sales.

謝謝接線員，也謝謝各位的參與。今天陪我一起的是我們的執行長彼得·卡爾迪尼。在我們發言完畢後，我們將回答各位的問題。在開始之前，我想提醒各位，管理層在本次電話會議中發表的評論將包含符合聯邦證券法的前瞻性陳述。其中包括關於建立實驗室財務前景以及公司產品開發和銷售計劃和時間表的聲明。

These forward-looking statements are based on management's current expectations and involve risks and uncertainties. For 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 establishment labs.com.

這些前瞻性陳述是基於管理階層目前的預期，並涉及風險和不確定性。如需了解可能影響我們業績或導致實際結果與這些聲明有重大差異的主要風險因素和不確定性，我建議您查閱我們最新的年度和季度報告（表格 10K 和表格 10Q），以及其他提交給美國證券交易委員會的文件，這些文件可在我們的網站 establishment labs.com 上查閱。

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.

我還想提醒您，我們的評論可能包含一些與我們業績相關的非公認會計準則財務指標，包括但不限於可以按固定匯率計算的銷售業績，或我們按調整後 EBITDA 披露的 EBITDA。

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.

如有非GAAP指標與可比較GAAP財務指標的調節表，請參閱我們網站上發布的今日新聞稿。

The content of this conference call contains time sensitive information accurate only as of the date of this live broadcast, February 24, 2026, except as required by law, established labs undertakes no obligation to revise or otherwise update any statements to reflect events or circumstances after the date of this call.

本次電話會議的內容包含時效性訊息，除法律另有規定外，此資訊僅在本次直播之日（2026 年 2 月 24 日）準確無誤。 Established Labs 不承擔任何義務修改或更新任何聲明以反映本次電話會議日期之後發生的事件或情況。

With that, it is my pleasure to turn the call over to Peter.

接下來，我很高興將電話交給彼得。

Good morning and thank you all for joining us today.

早安，感謝各位今天收看我們的節目。

Q4 2025 was another standout quarter for Establishment Labs. Fourth quarter revenue was $64.6 million an increase of 45.2% versus Q4 2024, including Motiva revenue in the US of $17.3 million.

2025 年第四季是 Establishment Labs 的另一個傑出季度。第四季營收為 6,460 萬美元，比 2024 年第四季成長 45.2%，其中包括 Motiva 在美國的營收 1,730 萬美元。

This brings our 2025 total revenue of $211.1 million an increase of 27.2% over 2024.

這將使我們 2025 年的總收入達到 2.111 億美元，比 2024 年成長 27.2%。

US motivo revenue in 2025 was $45.6 million a number that I'm sure significantly exceeded everyone's expectations.

2025 年美國 Motivo 的收入為 4,560 萬美元，我相信這個數字遠遠超出了所有人的預期。

As our business scaled, the operational leverage that we've been talking about is coming into focus. Q4 had a succeeding 70% gross margin for the second consecutive quarter, and our margins will continue to improve. Our fourth quarter net loss from operations was $3.9 million down 79% from Q4 2024.

隨著業務規模的擴大，我們一直在談論的營運槓桿作用也逐漸顯現出來。第四季毛利率連續第二季達到 70%，我們的毛利率將持續提高。我們第四季的營運淨虧損為 390 萬美元，比 2024 年第四季下降了 79%。

Our Q4 adjustment EBITDA was positive $5.5 million up from the negative $13.1 million we reported in Q4 2024.

我們第四季的調整後 EBITDA 為正 550 萬美元，而 2024 年第四季報告的為負 1310 萬美元。

This trend should continue throughout 2026, culminating in our first positive cash flow quarter this year.

這一趨勢應該會持續到 2026 年，並最終在今年實現我們第一個正現金流季度。

In 2027 we expect to be cash flow positive for the entire year and our margins should improve for years after that. With this trajectory and our ending cash balance of $75.6 million in 2025, we have no need for additional capital.

我們預計到 2027 年將全年實現正現金流，此後幾年利潤率將持續提高。按照目前的成長趨勢，加上我們 2025 年末現金餘額為 7,560 萬美元，我們不需要額外的資金。

As noted at the JPMorgan Healthcare conference, we are comfortable not only setting guidance for 2026, but also providing some visibility into 2027.

正如在摩根大通醫療保健大會上所指出的那樣，我們不僅有信心製定 2026 年的業績指引，而且也有信心對 2027 年的業績做出一些預測。

As such, we are giving guidance for 2026 of $264 million to $266 million.

因此，我們對 2026 年的業績預期為 2.64 億美元至 2.66 億美元。

And there may be some upsides to these numbers.

這些數字或許也有一些正面的面向。

At a minimum, this is a 25% growth, and we believe that 2027 we will see at least this level of growth as well.

至少，這將帶來 25% 的成長，我們相信到 2027 年，我們也將至少看到這一成長水準。

Q4 capped off a remarkable 2025 for Establishment Labs. We didn't just see the US market for growth in the years to come. We established ourselves as the company transforming the industry, materially changing and increasing the conversation about breast aesthetics.

2025 年第四季為 Establishment Labs 輝煌的表現畫上了圓滿的句號。我們不僅看到了美國市場在未來幾年的成長潛力。我們確立了自己作為行業變革者的形象，從根本上改變和提升了人們對乳房美學的討論。

The $45.6 million in US revenue, and approximate 20% augmentation market share exiting 2025, is something that took the last new entrant almost 10 years to achieve.

到 2025 年底，該公司在美國的收入將達到 4,560 萬美元，市佔率將達到約 20%，而上一個新進業者花了近 10 年才達到這項成就。

And we did it in one How do we accomplish this? Well, first off, there's been a complete lack of innovation in breast aesthetics for decades. We have had an active R&D pipeline since 2010, which continues today and is unparalleled in the industry.

我們只花了一年就做到了。我們是如何做到這一點的？首先，幾十年來，乳房美學領域完全缺乏創新。自 2010 年以來，我們一直擁有活躍的研發項目，這一趨勢至今仍在持續，並且在業界是無與倫比的。

Our R&D investment continues to translate into highly differentiated products that address significant unmet needs in the market.

我們的研發投入持續轉化為高度差異化的產品，以滿足市場上尚未滿足的重大需求。

When patients review or hear about the FDA study complication rates for today's commercially available implants, they recognize that Motiva should be part of the decision when selecting both a surgeon and an implant.

當患者查看或聽到 FDA 研究報告顯示目前市售植入物的併發症發生率時，他們意識到在選擇外科醫生和植入物時，Motiva 應該納入考慮範圍。

Last week's surgeons tell us that when patients are presented with different implant options during consultation, 9 out of 10 choose Motiva, even at a higher price point.

上週的外科醫生告訴我們，當患者在諮詢期間被告知不同的植體選擇時，十有八九會選擇 Motiva，即使價格更高。

This isn't just about data for them. Patients are gravitating towards Motiva when they compare implants in their hands. When doctors dig into the science and data behind Motiva, they find rigorous scientific literature that details our technologies and why our implants are designed to create better patient outcomes.

對他們來說，這不僅僅是數據的問題。患者在比較各種植體時，都傾向於選擇 Motiva。當醫生深入研究 Motiva 背後的科學原理和數據時，他們會發現嚴謹的科學文獻詳細介紹了我們的技術以及為何我們的植入物旨在創造更好的患者治療效果。

The process of consideration has been amplified and is actively discussed across social media.

這一考慮過程已被放大，並在社交媒體上引發了積極討論。

There is a new era of transparency that has evolved as women share their journey and talk openly about their aesthetic goals and decisions.

隨著女性分享她們的經歷，並公開談論她們的美學目標和決定，一個全新的透明時代已經到來。

An estimated 300,000 women get a primary breast augmentation every year in the United States, and it continues to be the number one aesthetic surgical procedure annually, but it has always been a secret shared quietly.

據估計，美國每年有 30 萬名女性接受初次隆乳手術，隆乳手術仍然是每年最受歡迎的美容外科手術，但這始終是一個鮮為人知的秘密。

Social media has created a new paradigm where aesthetic and beauty secrets have become normalized. We believe that the combination of our innovative products and this new era of transparency is creating meaningful market expansion, and we can already see the start of this trend.

社群媒體創造了一種新的範式，在這種範式下，美學和美容秘訣變得司空見慣。我們相信，我們創新的產品與這種透明化的新時代相結合，正在創造有意義的市場擴張，而我們已經可以看到這種趨勢的開端。

It is not just patients that are excited about Motiva. For the first time in a very long time, plastic surgeons have a product and a surgery to talk about. It's new. It's differentiated, and they are taking to social media to talk about it. Their excitement and passion for Motiva and what it means for breast augmentation comes through, and patients are responding.

不僅僅是患者對 Motiva 感到興奮。時隔多年，整形外科醫生終於又有了新的產品和手術可以談。這是新的。它與眾不同，人們紛紛在社群媒體上談論此事。他們對 Motiva 的熱情和對隆乳手術意義的理解令人興奮，患者也給予了積極的回饋。

We are very thoughtful in how we spend our marketing dollars and obviously compared to some of our competitors our resources are limited, but the marketing value we are receiving from patients and doctors is a competitive advantage and is very difficult to compete with.

我們在行銷經費的使用上非常謹慎，顯然與一些競爭對手相比，我們的資源有限，但我們從患者和醫生那裡獲得的營銷價值是一種競爭優勢，很難與之競爭。

Our innovation and its reception in the market is driving adoption, and plastic surgeons report to us that many patients come in asking for Motiva by name, whereas prior to Motiva, they would rarely ask for a brand.

我們的創新及其在市場上的反響正在推動產品的普及，整形外科醫生向我們反映，許多患者會直接點名要 Motiva，而在 Motiva 出現之前，他們很少會指定品牌。

All this has led to one of the fastest product launches in breast aesthetics history.

這一切促成了乳房美學史上最快的產品上市之一。

The momentum has continued in Q1 of 2026, with both January and the first two weeks of February exceeding our expectations.

這一勢頭延續到了 2026 年第一季度，1 月和 2 月的前兩週都超出了我們的預期。

Since launch in late 2024, we have onboarded over 1,500 accounts.

自 2024 年底推出以來，我們已經吸引了超過 1500 個帳戶。

We continue to sign up new practices every day.

我們每天都在不斷新增合作診所。

January and February are peak conference months for plastic surgeons, and Motiva continues to dominate the podium discussions, with surgeons actively seeking us out at these events to learn more and engage with us. It certainly appears our growth curve will continue.

一月和二月是整形外科醫生參加會議的高峰期，Motiva 繼續在講台討論中佔據主導地位，外科醫生們積極地在這些活動中尋找我們，以了解更多信息並與我們互動。我們的成長勢頭似乎還會繼續。

In a recent blinded survey of plastic surgeons, 88% said they either use or are interested in trying Motiva, with the top reasons including patient-driven demand, an unmatched safety profile, the benefits of smooth silk surface, and the opportunity for above the muscle placement.

在最近一項針對整形外科醫生的盲法調查中，88% 的受訪者表示他們正在使用或有興趣嘗試 Motiva，主要原因包括患者的需求、無與倫比的安全性、光滑絲綢表面的優勢以及可以放置在肌肉上方。

In the survey, 75% of surgeons noted they've been asked for an implant brand by name, and surgeons reported that 93% of the time, that brand was Motiva.

調查顯示，75% 的外科醫生表示他們曾被問及植入物品牌名稱，而外科醫生報告稱，93% 的情況下，該品牌是 Motiva。

Patients actively seeking out motiva is having a significant impact on account volumes.

患者積極尋求動力對帳戶數量產生了重大影響。

In that same survey, surgeons with greater than 50% Motiva share in their practices saw year over year growth in augmentation volumes that was more than double that of surgeons primarily using another brand.

同一項調查顯示，在診所中使用 Motiva 產品超過 50% 的外科醫生，其隆乳手術量逐年增長，是主要使用其他品牌產品的外科醫生的兩倍多。

This is important because while many early adopters have moved the majority of their volume to Motiva and are seeing the benefits of this on their practice volumes, the opportunity to grow our share of procedures and accounts remains significant.

這一點很重要，因為雖然許多早期採用者已經將大部分業務量轉移到 Motiva，並且看到了業務量方面的好處，但我們增加業務量和帳戶份額的機會仍然很大。

This is not surprising given how clinic onboarding has ramped up over the year and because many surgeons plan and schedule surgeries months in advance.

考慮到診所入駐人數在過去一年中大幅增加，以及許多外科醫生提前數月規劃和安排手術，這種情況並不令人驚訝。

As we move through 2026, we expect to see our share in these accounts to move meaningfully higher.

隨著我們邁入 2026 年，我們預計我們在這些帳戶中的份額將顯著提高。

These efforts are being supported by a best in class commercial organization.

這些努力得到了業內一流商業機構的支持。

In 2026, we plan to expand our US sales force with the addition of up to 15 more sales representatives, a majority of whom have already been hired.

2026 年，我們計劃擴大美國銷售團隊，增加最多 15 名銷售代表，其中大部分已經招募完畢。

This team of seasoned industry veterans are in plastic surgery accounts every day, pushing our share higher.

這支由經驗豐富的行業資深人士組成的團隊每天都在拜訪整形外科客戶，不斷提升我們的市場份額。

2025 was also the year we started to introduce the concept of minimally invasive breast augmentation through our early experience of Preservet.

2025 年，我們也開始透過 Preservet 的早期經驗引入微創隆乳的概念。

We had strong global demand and we're confident that patients and doctors in the US would be equally receptive.

全球需求強勁，我們相信美國的患者和醫生也會同樣接受。

If motiva implants alone were exciting in the US market, what would that technology, plus the promise of smaller incisions, minimal anesthesia, and fast recovery bring?

如果 Motiva 植體本身就能在美國市場引起轟動，那麼這項技術再加上更小的切口、更少的麻醉和快速恢復的承諾，又會帶來怎樣的驚喜呢？

The acceptance and demand outstripped even our own expectations.

市場接受度和需求甚至超出了我們自己的預期。

For decades, plastic surgeons contended these ideas were not important to patients.

幾十年來，整形外科醫生一直認為這些觀點對病人來說並不重要。

You just have to look at the social media response and know that patients feel very differently.

只要看看社群媒體上的反應就知道了，患者的感受截然不同。

We have two types of women choosing Preserv.

選擇 Preserv 的女性有兩種類型。

The first are women that are already committed to the idea of breast augmentation, but are now choosing Preserv at a much higher price point because of the benefits over traditional augmentation.

第一類是已經決定進行隆乳手術的女性，但由於 Preserv 比傳統隆乳手術具有更多優勢，因此她們選擇更高價格的 Preserv。

The second are women that were simply not interested in legacy breast augmentation procedure but are now considering and booking surgery.

第二類女性原本對傳統的隆乳手術不感興趣，但現在正在考慮並預約手術。

For that second group, it may have been the aversion to general anesthesia, the fear of extended downtime that disrupts daily life, or a number of other factors.

對第二組人來說，原因可能是對全身麻醉的厭惡、害怕長時間的停工會影響日常生活，或其他一些因素。

Regardless, they are now part of a whole new group of consumers considering the possibility for the first time.

無論如何，他們現在都屬於一個全新的消費群體，這個群體正在首次考慮這種可能性。

Of the organic leads that have come through the preserv section of our website pre-launch, 81% of patients looking to get connected with the surgeon said they are only interested in getting a breast augmentation if they can get Preserv.

在網站上線前，透過 Preserv 部分獲得的自然流量中，81% 的患者表示，如果能獲得 Preserv 服務，他們才有興趣進行隆乳手術。

This marks a meaningful paradigm shift in the industry with Motiva uniquely positioned as the only solution meeting evolving consumer interests.

這標誌著該行業發生了意義深遠的範式轉變，Motiva憑藉其獨特的優勢，成為唯一能夠滿足不斷變化的消費者需求的解決方案。

We charge about 2 times more for preserv than we do for traditional breast augmentation.

我們對乳房保留手術的收費大約是傳統隆乳手術的兩倍。

Preserve is not only expanding the market on a dollar basis, it's expanding procedure volumes as well.

Preserve 不僅在美元層面上擴大了市場份額，而且在手術量方面也取得了成長。

Based on our US early experience, we are seeing expansion in the category. Approximately 15% of preserve patients in the US reported they were not previously considering a breast augmentation prior to learning about the procedure.

根據我們在美國早期的經驗，我們看到該品類正在擴張。在美國，約有 15% 的乳房保留患者表示，在了解隆乳手術之前，她們從未考慮過隆乳。

In March we are moving from our early experience to a full launch.

三月份，我們將從早期經驗階段過渡到全面發布。

We have trained more than 90 surgeons, many of whom report patient waitlists and women traveling across the country to access the procedure.

我們已經培訓了 90 多名外科醫生，其中許多醫生反映患者候診名單很長，而且女性需要跨越全國各地才能接受手術。

In a recent survey with consumers on preserv.

最近一項針對消費者的調查顯示，

Over 55% of patients considering breast augmentations indicated a willingness to pay a premium, and surgeons are currently charging 30% to 50% more than traditional augmentation.

超過 55% 的考慮隆乳手術的患者表示願意支付更高的費用，目前外科醫生收取的費用比傳統隆乳手術高出 30% 到 50%。

The average breast augmentation in America is about $9000 and currently the average pricing for preserve is more than twice that.

在美國，隆乳手術的平均費用約為 9000 美元，而目前乳房保留手術的平均價格是其兩倍以上。

This pricing reflects the value of a less invasive tissue preserving option with faster recovery and minimal anesthesia.

這種定價體現了創傷較小、組織保護性強、恢復快、麻醉用量少的優點。

We expect to have at least 200 plastic surgeons trained by the end of 2026.

我們預計在 2026 年底至少培養出 200 名整形外科醫生。

If you're doing diligence around the impact that preserve is having, I suggest talking to surgeons that have performed a number of cases.

如果您正在認真研究該保護措施的影響，我建議您與已經進行過多次此類手術的外科醫生交談。

At least 5 surgeons have already done more than 40 cases in geographies that span coast to coast.

至少有 5 位外科醫生已經在橫跨美國東西海岸的地區完成了 40 多例手術。

Surgeons cite the benefits of preservative patients, but also to their practices.

外科醫生們不僅提到了保存病人的好處，也提到了他們自身實踐中的好處。

One plastic surgeon told me recently that preserv was game changing.

一位整形外科醫生最近告訴我，這種保存方法改變了遊戲規則。

He used to have a local practice, occasionally regionally. Now he has patients flying in from all over America.

他以前在當地行醫，偶爾也會在周邊地區行醫。現在他的病人來自美國各地。

Another plastic surgeon that methodically tracks her metrics reports that she's able to do 3 or 4 more operations per week with the time that Preserve saves her.

另一位有條不紊地追蹤各項指標的整形外科醫生表示，Preserve 為她節省的時間，讓她每周可以多做 3 到 4 台手術。

Our minimally invasive serging portfolio is a real win-win for all.

我們微創包邊產品組合對各方來說都是真正的雙贏之舉。

Patients are getting access to benefits that are incredibly important to them.

患者正在獲得對他們來說極為重要的福利。

Surgeons are able to charge more per patient and do more surgeries at the same time.

外科醫生可以向每位患者收取更高的費用，並同時進行更多手術。

Better experience for patients and better businesses for surgeons.

為患者帶來更好的體驗，為外科醫師帶來更好的業務發展。

In December 2025, we also submitted motiva implants to the FDA for approval in primary and revision breast reconstruction.

2025 年 12 月，我們也向 FDA 提交了 Motiva 植入物，以申請批准用於初次和修復性乳房重建。

Reconstruction represents a significant strategic opportunity as it effectively doubles our total addressable market in the United States while offering higher average selling prices.

重建項目代表著一個重要的戰略機遇，因為它有效地使我們在美國的潛在市場總量翻了一番，同時提供了更高的平均售價。

Motiba flora breast tissue expander is already in 200 facilities nationwide, and this footprint should continue to expand as we move closer to FDA approval.

Motiba Flora 乳房組織擴張器已在全國 200 家醫療機構投入使用，隨著我們越來越接近獲得 FDA 批准，這一覆蓋範圍應該會繼續擴大。

In addition, we remain active in communications with the FDA regarding our small size of submission, which will further expand our portfolio, meet a broader range of patient needs, and allow us to take a higher percentage of cases by surgeons already using Motiva.

此外，我們繼續積極與 FDA 溝通，討論我們小規模的申請，這將進一步擴大我們的產品組合，滿足更廣泛的患者需求，並使我們能夠承接更高比例的已在使用 Motiva 的外科醫生的病例。

Beyond these initiatives, Mia Ergonomics 2 and JEM are also part of the innovation pipeline that we're working to bring to the US market in the coming years.

除了這些舉措之外，Mia Ergonomics 2 和 JEM 也是我們正在努力在未來幾年內引入美國市場的創新產品線的一部分。

Along with our success in the US, our OU US performance remains strong and well diversified.

隨著我們在美國取得成功，我們的 OU 美國業務表現依然強勁且多元化。

A major focus for us in 2025 was our direct markets, and we have seen very good results.

2025 年，我們的重點之一是直銷市場，我們已經取得了非常好的成果。

The number of accounts in many of our direct markets continues to grow, underscoring the strength of demand.

我們許多直銷市場的帳戶數量持續成長，凸顯了市場需求的強勁。

European direct markets delivered more than 20% growth for the third consecutive quarter, led by outstanding performances in the UK, Germany, and Spain.

歐洲直接市場連續第三個季度實現超過 20% 的成長，其中英國、德國和西班牙的出色表現尤為突出。

In Latin America, results have stabilized in Brazil, while Argentina continues to post strong growth.

在拉丁美洲，巴西的經濟狀況趨於穩定，而阿根廷則持續保持強勁成長。

Additionally, our recent acquisition of Benelux exceeded our expectation in the 1st year.

此外，我們最近收購的 Benelux 在第一年就超出了我們的預期。

While distributor markets can fluctuate based on the timing of orders, we are seeing healthy demand globally.

雖然經銷商市場會根據訂單時間而波動，但我們看到全球需求依然強勁。

Across AAC, China remains a key focus, and we're actively working with the local distributor and seeing improved performance.

在整個AAC業務中，中國仍然是重點關注領域，我們正在積極與當地經銷商合作，並看到了業績的提升。

Our minimally invasive platform, Preserve and Mia continues to demonstrate strong momentum outside the United States.

我們微創平台 Preserve 和 Mia 在美國以外地區持續展現強勁的發展動能。

Preserve is now available in 33 global markets with demand exceeding expectations and more than 700 accounts opened.

Preserve 目前已在全球 33 個市場推出，需求超出預期，已開設超過 700 個帳戶。

MA outperformed the $8 million to $10 million guidance in 2025, and it has more than doubled the number of accounts compared to 2024.

MA 2025 年的業績超過了 800 萬至 1000 萬美元的預期，而且帳戶數量比 2024 年增加了一倍多。

Notably, all Mia clinics have adopted Preserve, enabling them to offer the benefits of a less invasive augmentation solution to a wider range of patients at price points far greater than a traditional breast augmentation.

值得注意的是，所有 Mia 診所都採用了 Preserve 技術，使他們能夠以遠高於傳統隆乳手術的價格，為更廣泛的患者群體提供侵入性較小的隆乳解決方案。

Globally, we expect demand for a minimally invasive platform to exceed $30 million in 2026 and continue to be a key growth driver in years to come.

預計到 2026 年，全球對微創平台的需求將超過 3,000 萬美元，並在未來幾年繼續成為關鍵的成長驅動力。

As I'm sure you have noted, we issued a second press release this morning around the management transition we're making effective March 9th, which is really about getting establishment labs ready for our next phase of growth.

正如您肯定已經注意到的，今天早上我們發布了第二份新聞稿，內容是關於我們將於 3 月 9 日生效的管理層過渡，這實際上是為了讓現有實驗室為我們的下一個增長階段做好準備。

Over the past several years, we have been focused on driving efficient execution and scalability.

過去幾年，我們一直專注於提高執行效率和可擴展性。

We are now adding additional leadership to sustain operational momentum while ensuring oversight of initiatives that require deep business expertise and strong leadership.

我們現在正在增加領導層，以保持營運勢頭，同時確保對需要深厚業務專業知識和強大領導力的各項舉措進行監督。

With this, we are delighted to have Raj transition into the role of SVP Global strategy.

我們很高興 Raj 將過渡到全球策略高級副總裁一職。

His deep understanding of our business, strategic perspective, and broad industry experience will be instrumental.

他對我們業務的深刻理解、策略眼光和廣泛的行業經驗將發揮重要作用。

There are a number of initiatives underway that should keep us at a very high growth rate for the foreseeable future, and exactly how we execute these requires extensive planning and oversight.

目前正在推行多項舉措，這些舉措將在可預見的未來使我們保持非常高的成長率，而如何執行這些舉措則需要廣泛的規劃和監督。

Along with this, we are pleased to welcome Cassandra Harris as our new Chief Financial Officer. Her strong background in operational excellence and proven track record of strengthening financial discipline while enabling growth will be critical as we execute on our priorities ahead.

同時，我們很高興地歡迎 Cassandra Harris 擔任我們的新財務長。她擁有卓越的營運能力和在加強財務紀律的同時促進成長方面的卓著業績，這對我們執行未來的優先事項至關重要。

I will now turn the call over to Raj.

現在我將把通話轉給拉傑。

Thank you, Peter.

謝謝你，彼得。

Total revenue for the fourth quarter was $64.6 million an increase of 45.2% from last year.

第四季總營收為 6,460 萬美元，比去年同期成長 45.2%。

Excluding the positive impact of foreign exchange in the quarter, growth would have been approximately 39.4%. Sales for Motti in the United States were $17.3 million.

若不計入本季外匯匯率的正面影響，成長率約為39.4%。 Motti在美國的銷售額為1,730萬美元。

On a geographic basis in the 4th quarter, sales in Europe, Middle East, and Africa were 41% of the global total. We saw strong growth in the region overall, including another good quarter in our direct markets where we exceeded 20%, as well as good demand from our distribution partners.

從地理來看，第四季歐洲、中東和非洲的銷售額佔全球總銷售額的 41%。我們看到該地區整體實現了強勁成長，包括我們的直接市場又一個季度表現良好，成長率超過 20%，同時我們的分銷合作夥伴也提出了良好的需求。

Sales in the United States were 26.8% of the global total.

美國市場的銷售額佔全球總銷售額的 26.8%。

Latin America was 18% of sales. Brazil remained stable, and we saw good growth in Argentina, or other direct market in the region, as well as from our distributors.

拉丁美洲的銷售額佔總銷售額的18%。巴西市場保持穩定，我們在阿根廷或該地區的其他直接市場以及我們的經銷商那裡都看到了良好的成長。

Asia Pacific was 14.1% of sales. Results in the quarter reflected the comp in a year ago period where we saw sales to our Chinese distributor, as well as the normal ebbs and flows of distributor purchase timing.

亞太地區佔銷售額的14.1%。本季業績反映了去年同期的情況，當時我們對中國分銷商進行了銷售，同時也受到了分銷商採購時間正常波動的影響。

Gross profit for the fourth quarter was $45.5 million or 70.5% of revenue.

第四季毛利為 4,550 萬美元，佔營收的 70.5%。

This was a 200 basis point increase compared to the 68.5% of revenue last year.

與去年 68.5% 的收入相比，這一數字成長了 200 個基點。

Overall in 2025, our gross profit margin increased 330 basis points compared to 2024, primarily the result of the higher margin sales in the United States.

2025 年，我們的毛利率總體上比 2024 年提高了 330 個基點，這主要是由於美國市場毛利率較高的銷售所致。

SG&A expenses were $44.0 million and were flat compared to the fourth quarter of 2024. R&D expenses for the third quarter were $5.4 million.

銷售、一般及行政費用為 4,400 萬美元，與 2024 年第四季持平。第三季研發費用為 540 萬美元。

Total operating expenses for the fourth quarter were in line with the year ago period at $49.5 million. Adjusted EBITD was positive $5.5 million in the fourth quarter. This compared to a loss of $13.1 million in the fourth quarter of last year.

第四季總營運支出與去年同期持平，為 4,950 萬美元。第四季調整後EBITD為正550萬美元。相較之下，去年第四季虧損1,310萬美元。

This is our second consecutive quarter of positive adjusted EBITDA.

這是我們連續第二季實現調整後 EBITDA 為正。

The $18.6 million dollar improvement year over year in adjusted EBITDA was driven by the strong sales and the higher gross profit in the United States.

經調整的 EBITDA 較去年同期成長 1,860 萬美元，主要得益於美國強勁的銷售額和更高的毛利。

But we've also been very focused on managing our operating expenses overall.

但我們也一直非常注重控制整體營運成本。

Over the course of 2025, we grow US commercial operations and we launched a second offering on our minimally invasive portfolio.

在 2025 年，我們擴大了美國的商業運營，並推出了微創產品組合中的第二款產品。

We're able to do this and still generate increasing profitability by finding efficiencies across all parts of the organization and making structural changes when needed.

我們能夠做到這一點，並且透過在組織的各個部門提高效率並在需要時進行結構性變革，還能持續提高獲利能力。

Cash increased $4.9 million in the fourth quarter to $75.6 million.

第四季現金增加 490 萬美元，達到 7,560 萬美元。

The increase was primarily the result of reduced operating cash use as well as inflows from option exercises.

成長的主要原因是經營現金使用減少以及選擇權行使帶來的現金流入。

For 2026, our initial revenue guidance is for $264 million to 266 million, an increase of 25.1% to 26% over 2025.

2026 年，我們的初步營收預期為 2.64 億美元至 2.66 億美元，比 2025 年成長 25.1% 至 26%。

We expect our O US business will grow in the single-digits and the US will exceed 30% of overall sales, which is up from approximately 22% in 2025.

我們預計美國業務將實現個位數成長，美國銷售額將佔總銷售額的 30% 以上，高於 2025 年的約 22%。

Gross margins are expected to decrease 200 to 300 basis points.

預計毛利率將下降 200 至 300 個基點。

Operating expenses in total are expected to be approximately $195 to $200 million in 2026.

預計到 2026 年，營運總支出約為 1.95 億至 2 億美元。

However, as we saw in 2025, there can be some variability in quarterly spending levels based on the timing of expenses.

然而，正如我們在 2025 年所看到的，季度支出水準可能會因支出時間的不同而有所波動。

We expect to be adjusted EBIDD positive every quarter in 2026.

我們預計到 2026 年，每個季度調整後的 EBIDD 都將為正值。

Cashew will continue to prove over the course of 2026.

腰果將在2026年繼續證明其價值。

Our free cash use is expected to be less than half of what it was in 2025, and we expect to reach cash flow positive this year without the need for any further equity raises.

預計到 2025 年，我們的自由現金流使用量將不到當時的一半，我們預計今年就能實現正現金流，而無需進一步籌集股權資金。

Our credit facility went to the last year of its term in April, and we are considering a number of refinancing options.

我們的信貸額度在四月到期，目前正考慮多種再融資方案。

Overall, our financial outlook reflects a significant momentum in our business. The adoption of motive in the US is still early, with significant room to drive further practice adoption as well as penetration within accounts. Preserve will add to both procedure growth as well as our realized ASPs.

總體而言，我們的財務前景反映了我們業務的強勁發展勢頭。在美國，動機分析的應用仍處於早期階段，在推動實踐應用和客戶滲透方面還有很大的提升空間。Preserve 將促進手術流程的成長，並提高我們實際的平均售價。

Outside the US, global demand remains good, and our focus on direct markets and our minimally invasive portfolio should lead to another solid year of results.

在美國以外，全球需求依然良好，我們對直接市場的關注以及我們微創的產品組合應該會帶來另一個穩健的業績年。

Down the P&L, gross margins are benefiting from the positive geographic and product mix playing out.

從損益表來看，毛利率受益於積極的地域和產品組合策略。

Even with continued investments, incremental operating spending over the next few years will be at a rate well below top-line growth. This leverage should allow us to achieve cash flow profitability in the second half of the year and is the basis of the meaningful and increasing earnings we expect to see in 2027 and beyond.

即使持續投資，未來幾年新增營運支出也將遠低於營收成長速度。這種槓桿作用應該能夠讓我們在今年下半年實現現金流盈利，也是我們預期在 2027 年及以後看到顯著增長的收益的基礎。

We continue our work to make ESTA eligible for inclusion in a number of indices, including the Russell. Recent updates have increased our confidence that we will be included this year.

我們將繼續努力，使 ESTA 符合納入多個指數的條件，包括羅素指數。最近的消息增強了我們今年能夠入選的信心。

Finally, as Peter mentioned, I'm moving into a new role at Establishment Labs. With the company on good financial footing, Peter and I have been discussing the best way for us to realize the significant potential we have to create shareholder value.

最後，正如彼得所提到的，我將在 Establishment Labs 擔任新職位。公司財務狀況良好，我和彼得一直在討論如何才能最好地發揮我們創造股東價值的巨大潛力。

Esther is in a very unique situation with unmatched innovation in products and a pipeline that even further distances us from our competitors.

Esther 處於非常獨特的地位，擁有無與倫比的產品創新能力和產品線，這使我們與競爭對手之間的差距進一步拉大。

To realize this, effective execution is the key.

要實現這一點，有效執行是關鍵。

The company has grown very organically over the past 20 years, and there are a number of areas that have the opportunity to be strengthened.

過去 20 年，公司發展非常穩健，但仍有許多領域需要加強。

After 5 years as CFO, I'm looking forward to a new challenge of leading our global strategy.

在擔任財務長 5 年後，我期待著領導公司全球策略的新挑戰。

In this new role, I remain actively engaged in driving our performance, but the day to day finance function and CFO role will transition to Sandra Harris, who was selected after an extensive search.

在這個新職位上，我將繼續積極參與推動公司業績，但日常財務職能和財務長的角色將移交給桑德拉·哈里斯，她是經過廣泛搜尋後被選中的。

With that, I will turn the call back to Peter.

這樣，我就把電話轉回給彼得了。

Thank you, Raj.

謝謝你，拉傑。

While continuing to invest selectively, we are maintaining an investment pace well below the expected top-line growth.

在繼續進行選擇性投資的同時，我們將投資速度維持在遠低於預期營收成長的水平。

We expect to achieve free cash flow positive in 2026 with meaningful earnings beginning in 2027.

我們預計在 2026 年實現自由現金流為正，並從 2027 年開始獲得可觀的收益。

I'd like to thank the entire organization for a great 2025.

我要感謝整個組織，感謝他們讓2025年如此精彩。

This year we remain focused on disciplined execution and building a global category leader.

今年我們將繼續專注於嚴謹執行，打造全球品類領導者。

Operator, we're ready to take your questions.

接線員，我們已準備好回答您的問題。

Thank you. We will now conduct a question-and-answer session. If you would like to ask a question, please press star one on your telephone keypad.

謝謝。接下來我們將進行問答環節。如果您有任何疑問，請按下電話鍵盤上的星號鍵 1。

As a reminder, this conference is being recorded, a confirmation tone will indicate your line is in the question queue. You may press 2 to remove yourself from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the keys. Once again, that's 1 to ask a question at this time. One moment while wepo for the first question.

提醒各位，本次會議正在錄音，確認音表示您的提問已進入佇列。您可以按 2 將自己從佇列中移除。對於使用揚聲器裝置的參與者，可能需要在按鍵前拿起聽筒。再次提醒，此時只有 1 個問題可以提問。請稍等片刻，我們先回答第一個問題。

The first question comes from Josh Jennings with TD Cowan. Please proceed.

第一個問題來自 TD Cowan 的 Josh Jennings。請繼續。

Hi, good morning. Thanks for taking the questions and congratulations to a strong end of the year and excited for you, Raj, in your new role.

您好，早安。感謝您回答問題，恭喜您圓滿結束這一年，也為您在新職位上的表現感到興奮，Raj。

I was hoping to just start on the minimally invasive portfolio. I mean, it seems clear that Preserve and Mia are pulling patients off of the sidelines. A couple of years back, I think prior to your tenure, Peter, the team had kind of put forward the potential for the minimumvasive portfolio to. To grow the market and grow breast augmentation procedure volumes, maybe even double them, but can you just maybe not want to put that stake back in the ground, but can you just talk about.

我原本希望先從微創手術著手。我的意思是，很明顯，Preserve 和 Mia 正在把病人從邊緣拉回來。幾年前，我想應該是在你任職之前，Peter，團隊曾提出過微創產品組合的潛力。為了擴大市場並增加隆乳手術量，甚至可能翻一番，但你可能不想再重新投入，但你能談談嗎？

The optimism and the trajectory of the market with minimally invasive offerings from establishment coming through.

市場前景樂觀，發展軌跡也與現有機構推出的微創產品和服務相符。

Yeah, thank you, Josh. I mean what we are seeing.

謝謝你，喬許。我的意思是，我們現在看到的。

In the US markets with the minimally invasive platform from the early experience in the US is extremely positive. I think you know with the benefits of no general anesthesia, smaller scars, faster recovery, I think that really resonates with patients and we're seeing that in the marketplace and also with some of the surveys when we talk about 14%. Of patients that decide to do breast augmentation. We're not considering until they heard about Preserve, and that's in our early experience survey in the US. So it's a real driver for the, what we think is not only to drive share for us in the market, but also to bring new patients and new women into the category. So we're really seeing that benefit and We think that that's going to continue to be a key driver. It's going to be a bigger part of our business as we go throughout this year as well as next, and our estimate and what we put in in terms of the guidance, over $30 million this year, and we feel very confident with that. So this will be a real driver for us this year as well as into the future.

在美國市場，微創平台的早期經驗非常積極。我認為，手術無需全身麻醉、疤痕更小、恢復更快，這些優點確實能引起患者的共鳴，我們在市場上也看到了這一點，一些調查也證實了這一點，例如 14% 的受訪者表示他們對此表示贊同。決定進行隆乳手術的患者。直到他們聽說了 Preserve，我們才開始考慮這個問題，這是我們在美國的早期經驗調查得出的結論。所以，我們認為這不僅能提高我們在市場上的份額，還能吸引新的患者和女性加入這個品類中，這確實是一個重要的驅動力。所以我們確實看到了這種好處，我們認為這將繼續成為一個關鍵驅動因素。在今年乃至明年，它將成為我們業務中越來越重要的組成部分，我們預計今年將超過 3000 萬美元，我們對此非常有信心。因此，這將是我們今年以及未來發展的重要驅動力。

Excellent. Maybe just one follow-up. I appreciate you laying out US revenues being roughly 30%. You are, planning on adding reps, around 30% higher number. Maybe just talk about where you're pulling these reps from. Are you still taking all-star veterans from the competition in the breast implant sector or the aesthetic sector?

出色的。或許只需要一次後續跟進。感謝您指出美國收入約佔 30%。你打算增加重複次數，數量大約會增加 30%。或許可以談談你從哪裡獲得這些訓練機會。你們是否還在從隆乳手術領域或整形美容領域招募經驗豐富的全明星選手？

And just remind us of how the productivity can ramp for these new reps as they come on board over the course of 2026. Thanks for taking the question.

也要提醒我們，隨著這些新代表在 2026 年陸續加入，他們的生產力將會如何提升。感謝您回答這個問題。

Yeah, thanks Josh. I mean I think one of the key drivers for our success in the US market is, we've been able to put together a best in class organization, so if you couple that with what we believe is the best products from a performance and a safety profile and bringing together with the best in class organization, and we're very focused on the type of reps that we bring to establishment labs and we are continuing to focus on.

謝謝你，喬希。我認為我們在美國市場取得成功的關鍵驅動因素之一是，我們能夠組建一流的組織，再加上我們認為在性能和安全方面都是最好的產品，以及一流的組織，我們非常注重我們帶到實驗室的代表類型，並且我們將繼續專注於此。

Reps that have significant industry experience that have a very good reputation in the market that have a very strong track record and I think what's what's very positive for us is that a lot of these reps see us as very attractive opportunities and that will continue to be a key driver for us in in this year as well as into the future.

那些擁有豐富行業經驗、在市場上享有良好聲譽、業績斐然的銷售代表，我認為對我們來說非常積極的一點是，許多這樣的銷售代表都把我們視為極具吸引力的機會，這將繼續成為我們今年以及未來發展的關鍵驅動力。

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

下一個問題來自 Needham and Company 的 Mike Matson。請繼續。

Yeah, thank, thanks for taking my question. So just want to start with one on reconstruction in the US. So can maybe just talk about how you plan to launch, into that market and you do get the FDA approval. Do you need specialist reps? Do you need maybe like a corporate accounts type, sales team and, maybe just talk about the importance of hospital contracts there.

好的，謝謝您回答我的問題。所以我想先從美國重建問題談起。所以或許可以談談你計劃如何進入那個市場，以及如何獲得FDA的批准。您需要專業的銷售代表嗎？您是否需要一個類似企業客戶經理類型的銷售團隊，或者只是想和他們談談醫院合約的重要性？

Yeah, thanks, Mike. I mean, as you see and you know we've highlighted that the recon indication is a, really large opportunity for us. I mean it really doubles the market, potential for us, and we've already kind of seeded the market with some of the.

謝謝你，麥克。我的意思是，正如你所看到的，我們也強調過，勘探跡象對我們來說是一個非常大的機會。我的意思是，這確實使我們的市場和潛力翻了一番，而且我們已經用一些產品開拓了市場。

With Flora we're in over 200 accounts. As we get closer to the launch, we will be expanding, obviously expanding our sales force. We'll probably look at a combination of some reps that will be hybrid, and then we'll have some dedicated reps, specifically for the larger hospital, network, and you know I think that we need to make sure that we have the right coverage, right sales support to ensure that we really capitalize.

我們與 Flora 合作，已擁有超過 200 個帳戶。隨著發布日期的臨近，我們顯然會擴大規模，包括擴大我們的銷售團隊。我們可能會考慮採用混合型銷售代表，同時也會安排一些專職銷售代表，專門服務規模較大的醫院和醫療網絡。我認為我們需要確保擁有合適的覆蓋範圍和銷售支持，以確保我們真正能夠充分利用這些資源。

On that opportunity and you know as I mentioned before we've already gotten some seating in terms with the floor so I think the the ramp up will be a little bit quicker and you know I think but as it relates to the the sales force we want to make sure we have some specific coverage but we're also going to be leveraging the existing sales force.

抓住這個機會，正如我之前提到的，我們已經在場地方面獲得了一些座位，所以我認為啟動速度會更快一些。至於銷售團隊，我們希望確保有一些特定的覆蓋範圍，但我們也將充分利用現有的銷售團隊。

Okay, got it. And then the international growth was a fair bit stronger this quarter. So was there any kind of one-offs in their stocking orders or anything like that? Or is this truly reflective of the underlying procedure growth that you're seeing?

好的，明白了。而且，本季國際市場的成長動能相當強勁。那麼他們的進貨訂單是否有任何特殊情況或類似情況？或者，這是否真正反映了您所看到的程式本身的成長？

Yeah, I mean, I think, listen, this year we made a very strategic focus on driving our direct markets.

是的，我的意思是，我認為，聽著，今年我們非常重視策略性地推動我們的直接市場發展。

And you know we've really been successful in terms of driving growth in those markets. We've allocated resources from a supply as well as investment standpoint. We made some organizational changes and you're seeing the benefits of that. We've had 20% growth the last three quarters. Preserve Bay is also helping to drive that as well as we increase the number of accounts. But in general I would say that the demand across all our markets is fairly stable and you know in terms of how we finished the quarter, I don't think there was any, necessarily any stocking orders. It's just sometimes what you'll find in the distributor markets.

你知道，我們在推動這些市場成長方面確實取得了成功。我們已經從供應和投資的角度分配了資源。我們進行了一些組織結構調整，您現在看到了這些調整帶來的好處。過去三個季度，我們的成長率達到了20%。Preserve Bay 也在推動這一目標的實現，同時我們也在增加帳戶數量。但總的來說，我認為我們所有市場的需求都相當穩定，而且就我們本季的收官情況而言，我認為並沒有任何庫存訂單。這就是你在經銷商市場有時會遇到的情況。

There is, some, different periods, it's not always a straight line, it's a little bit choppy in terms of that, but you know there was no efforts in terms of, any type of additional inventory or stocking it's just really based on the demand that we're getting in the marketplace and it's also based on the good execution.

雖然存在一些不同的時期，它並不總是一條直線，在這方面會有些波動，但你知道，我們並沒有採取任何額外的庫存或囤貨措施，這完全取決於我們在市場上獲得的需求，也取決於良好的執行力。

No, I think that's fair. I mean, it's, as Peter noted, there's always some ebbs and flows in the distributor markets, in particular based upon the timing of orders, but overall demand remains very healthy across all the regions, and the direct markets which we control ourselves obviously are doing very well right now. We're executing at a high level.

不，我覺得很公平。我的意思是，正如彼得指出的那樣，分銷市場總會有一些起伏，特別是取決於訂單的時間，但總體而言，所有地區的需求仍然非常健康，而我們自己控制的直接市場目前顯然也做得非常好。我們的執行力很強。

Okay, great, thanks guys.

好的，太好了，謝謝大家。

The next question comes from Anthony Patron with Mizuho. Please proceed.

下一個問題來自瑞穗銀行的 Anthony Patron。請繼續。

Thanks and congrats on a strong year. Congrats, Raj, on the transition and Cassandra, welcome to the team, if you're on the call. So maybe just, maybe around the horn globally. I know the macro's come up quite a bit. It seems a little bit better maybe on a, 3 to 6 month basis here when you think of the regions and maybe just a quick recap, where do you see the underlying augmentation markets US.

謝謝，也恭喜你們度過了碩果累累的一年。恭喜 Raj 順利過渡，Cassandra，如果你在電話會議上，歡迎加入團隊。所以也許只是，也許只是在全球。我知道宏命令經常被提及。從 3 到 6 個月的角度來看，情況似乎略有好轉，考慮到各個地區的情況，或許可以快速回顧一下，您認為美國潛在的增強市場在哪裡？

And then some of the core US markets, thinking of Europe, China, Korea, and then I'll have a follow-up question.

然後是美國的一些核心市場，像是歐洲、中國、韓國，之後我還有一個後續問題。

Yeah, Anthony, the question's really on the underlying markets. I mean, generally the markets feel healthy right now. The US, for us we're growing at a high rate, so it's, we're kind of well exceeding what's happening in the underlying market. But as we've noted, there does seem to be some increased interest in breast augmentation procedures, and I think a lot of that's been driven by the activities we're doing certainly, but it does feel like the market in the US is very healthy, and we hear that from surgeons as well with. Surgery schedules booked out and lots of interest. So overall I'd say the US remains quite healthy. Internationally, frankly, we're seeing the same thing, in our distributor markets. You've seen north of 20% growth now for several quarters.

是的，安東尼，問題的關鍵在於基礎市場。我的意思是，整體而言，目前市場感覺很健康。就我們而言，美國市場成長速度很快，所以我們的成長速度遠遠超過了基礎市場的整體成長速度。但正如我們所指出的，人們對隆乳手術的興趣似乎有所增加，我認為這很大程度上是由我們正在進行的活動推動的，但感覺美國的市場非常健康，我們也從外科醫生那裡聽到了同樣的說法。手術日程已全部排滿，諮詢量大。所以總的來說，我認為美國經濟依然相當健康。坦白說，我們在國際分銷市場也看到了同樣的情況。你們已經連續幾個季度看到超過 20% 的成長了。

You know that again is pretty indicative of what's happening on the ground and also with our share taking and then in distributor markets likewise, the demand seems to be quite good. China, you mentioned has been a market that we've highlighted as had some challenges. It's taking a lot of focus of management in the company. We're spending a lot of time with that distributor, and frankly we're seeing the results, starting to turn a little bit. And so overall I'd say, the market's remained healthy for us, and you can see it in the numbers.

你知道，這再次很好地表明了實際情況，也反映了我們的市場份額增長情況，以及分銷商市場的需求情況，同樣，需求似乎相當不錯。您提到的中國市場，是我們重點關注的、面臨一些挑戰的市場之一。這佔據了公司管理階層的大量精力。我們花了很多時間和那家經銷商溝通，坦白說，我們已經看到成效了，情況開始有所改善。所以總的來說，我認為市場對我們來說依然健康，這點從數據中也可以看出來。

And that's helpful and a follow-up would be on just the establishment labs mix, when you think of Preserv a year coming in.

這很有幫助，後續工作將僅限於已建立的實驗室混合物，考慮到 Preserv 即將到來一年。

And obviously good feedback, but also reconstruction.

當然，好的回饋很重要，但重建也很重要。

What what do you think, I guess preserve can be as a percent of total revenues, once we get into the sort of 27 to 28, time range, can it eventually be 50% of, let's say US revenues, and if that's the case, what do you think the tailwind looks like to your gross margin? Thanks.

您認為，一旦我們進入 27 到 28 年的時間範圍，預付金額佔總收入的百分比是多少？最終能否達到美國營收的 50%？如果是這樣，您認為這對您的毛利率會有怎樣的利多？謝謝。

Yeah, I mean, Anthony, it is early still, right? So Preserve launched, essentially a year ago in Brazil. It was February of 2025, right? And the demand we've seen has been very strong, the US globally, there's a lot of interest. It has really, I think, caught the attention of surgeons, it fits into the way that they do surgery. A number of them are saying, why would I do surgery any other way, frankly.

是啊，安東尼，現在還早呢，對吧？所以 Preserve 大約一年前在巴西成立。那是2025年2月，對吧？我們看到的需求非常強勁，無論是在美國還是在全球範圍內，都引起了廣泛關注。我認為它確實引起了外科醫生的關注，它符合他們的手術方式。坦白說，他們中的許多人都說，我為什麼要選擇其他手術方式？

And so your numbers of getting to 50%, are not outside the realm of possibilities. I mean, I think we could see that kind of penetration.

所以，你所說的達到 50% 的目標並非不可能。我的意思是，我認為我們可能會看到這種滲透。

And to your point about what it does to our gross margins, the ASPs, we realize for a preserve a case relative to a case that only uses the implants, it's about twice the revenue for us as a company, and they are much higher margins. So it is a tailwind to what you're going to see on the gross margin side that combined with the ASPs in the US, what's going to happen with Recon, it just adds to a number of initiatives that are going to support the gross margins going significantly higher over time.

至於您提到的它對我們的毛利率和平均售價的影響，我們意識到，對於一個保留病例來說，相對於一個只使用植入物的病例，我們公司的收入大約是後者的兩倍，而且利潤率也高得多。因此，這將有利於毛利率的成長，再加上美國的平均售價，以及 Recon 的發展，這些因素共同促成了一系列舉措，這些舉措將隨著時間的推移顯著提高毛利率。

Thanks.

謝謝。

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

下一個問題來自 BTIG 的 SAM Eber。請繼續。

Hi, good morning. Thanks for taking the questions here. Maybe I can come back to the US for just a second and Peter, get your thoughts on some of the momentum you called out in the early days of 2026. And then I guess where you think you are along this, growth trajectory, is the long-term outlook for share gains still around the same goalpost that you've laid out in the past.

您好，早安。感謝您回答這些問題。也許我可以回美國一會兒，彼得，聽聽你對你在 2026 年初提到的一些發展勢頭的看法。那麼，我想您認為您目前所處的成長軌跡，以及您過去設定的長期市佔率成長目標，是否仍與此類似。

Yeah, thanks, SAM.

是啊，謝謝你，SAM。

We continue to have very strong momentum going into 2026.

進入2026年，我們依然保持著非常強勁的發展勢頭。

As I mentioned in the prepared remarks, there's a lot of opportunity to continue to gain share in the accounts that we're already in as we increase the utilization rate as the surgeons work through their scheduling. We're also going to be continuing to add accounts, so put more accounts on the top of the funnel. So that's going to be significant, drivers for us, as we mentioned. Also we're going to be adding up to 15 reps, and a bulk of them have already been, brought on. We started that process and we mentioned in the last earnings call that we're going to start that process the end of last year, so we've had close to 10 reps, join the organization so far and we're going to continue to bring those reps. So that's going to be a key driver for us.

正如我在準備好的演講稿中提到的，隨著外科醫生們安排手術，我們提高利用率，從而在我們已經擁有的客戶中繼續獲得大量市場份額的機會。我們也會繼續增加帳戶，所以請在銷售漏斗的頂端放置更多帳戶。所以，正如我們之前提到的，這對我們來說將是重要的驅動因素。此外，我們還要增加 15 次重複次數，其中大部分已經完成。我們已經啟動了這項流程，並在上次財報電話會議上提到，我們將在去年年底啟動這項流程，到目前為止，已有近 10 名代表加入了我們的組織，我們將繼續引進這些代表。所以這將是我們前進的關鍵動力。

Then you overlay the fact that we're going to be launching Preserve and and the performance that we've seen outside the US, but also in terms of the early experience it's creating a lot of excitement in in the US market, so that'll continue to be a key driver for us and.

然後，考慮到我們將推出 Preserve，以及我們在美國以外地區看到的表現，還有早期經驗表明它在美國市場引起了很大的轟動，因此這將繼續成為我們的關鍵驅動力。

In 2026 we're we're expecting to get the smaller sizes approved in the first half of this year and depending on the FDA, but we're very confident we should have that in the first half of the year.

2026 年，我們預計今年上半年就能獲得較小尺寸產品的批准，具體時間取決於 FDA 的審批，但我們非常有信心在今年上半年就能實現。

And that's just going to really be the start of the the super cycle of innovation that we mentioned before with the recon indication which we are expecting to be a key driver for us in 2027, also looking at Ergo 2 which will enable us to bring Mia to the marketplace. So you know our plan is still the same. We expect to be a dominant share in the US market. We're on that path to get there and. I think that's probably going to happen a little bit sooner than, I think we originally planned just based on the strong momentum we've had so far.

而這只是我們先前提到的超級創新週期的開始，我們預計重建指標將成為我們在 2027 年的關鍵驅動力，同時我們也關注 Ergo 2，這將使我們能夠將 Mia 推向市場。所以你知道我們的計劃仍然不變。我們預計將在美國市場佔據主導地位。我們正在朝著這個目標前進。我認為，鑑於我們目前取得的強勁勢頭，這件事可能會比我們最初計劃的要早一些發生。

Yeah, and SAM, I, if you look at the guidance we've given, for the US for it to exceed 30% of our sales, it's almost a third of our sales will be coming from the US, if not more, in the second full year. So we, we've got a lot of momentum in the US is going very well.

是的，SAM，如果你看看我們給出的指導意見，美國市場的銷售額要超過我們總銷售額的 30%，也就是說，在第二個完整年度，我們近三分之一的銷售額將來自美國，甚至可能更多。所以，我們在美國的發展勢頭非常強勁，進展也很順利。

Yeah, really helpful there. And then maybe just following up on the last point. Obviously you guys have a lot of, organic opportunities with minimally invasive recon, but maybe longer-term. Are there any gaps in the portfolio where maybe you're looking at that, you have this, the infrastructure now and where maybe you could be adding additional capabilities, to the portfolio.

是的，真的很有幫助。然後或許可以就最後一點做個補充。顯然，你們有很多機會，可以透過最小侵入性的偵察方式進行有機開發，但這可能是長期的。您的投資組合中是否存在任何差距？例如，您現在擁有這些基礎設施，但或許可以添加其他功能來完善您的投資組合。

Yes, SAM, it's a good question, and I think it's part of the reason for my transition, into this global strategy role is that, with the financial performance of the company in a very good spot, there are things like you're describing, business development, go to market strategies, the way that we prioritize things in our portfolio of innovation. That can now spend more time focusing on right because there are significant opportunities as you're describing to continue to expand what we're doing and to really realize the potential of what this company has put into motion.

是的，SAM，這是一個很好的問題，我認為我轉型擔任全球戰略角色的部分原因在於，公司目前的財務業績非常好，因此存在一些像你所描述的事情，例如業務發展、市場進入戰略以及我們如何確定創新組合中的優先事項。現在我們可以花更多時間專注於正確的事情，因為正如你所描述的，存在著巨大的機會，可以繼續擴大我們正在做的事情，並真正實現這家公司已經啟動的專案的潛力。

Really awful. Congrats on the the transition.

真是太糟糕了。恭喜你順利完成過渡。

Here. The next question comes from Alan Gong with JPMorgan. Please proceed.

接下來這個問題來自摩根大通的Alan Gong。請繼續。

Thanks for the question. You touched upon it already in response to some other questions, but I'm just curious about the contribution you're currently factoring into the 2026 guide from some of the, pipeline products you have between small sizes and reconstruction. Is reconstruction going to be more of a 2027 story and how quickly can you really ramp that up once you get the approval since as you've mentioned, you're already seeded in around 200 hospital facilities.

謝謝你的提問。您在回答其他一些問題時已經提到過這一點，但我只是好奇，您目前在 2026 年指南中考慮的一些管道產品（介於小規模和重建之間）的貢獻是什麼。重建工作是否會在 2027 年才開始？一旦獲得批准，你們能以多快的速度真正加快進度？正如您所提到的，您已經在大約 200 家醫院設施中開展了專案。

Yes, so on reconstruction, it is likely a 2027 and 2028 and beyond the story for us, right, because obviously it's still with the FDA.

是的，所以重建手術方面，對我們來說，可能要到 2027 年、2028 年甚至更晚才能見分曉，對吧，因為很明顯，它還在等待 FDA 的批准。

We nothing has changed our opinion that that product is approvable and should be very soon, but then there is the blocking and tackling of simply getting into hospitals, right? It takes time to work through the VAC committees and to get on contracts and things, and that will take time, but. But what we've already done is we've we've seen strong interest from hospitals already. We're already in a number of them and there's a lot of interest in recon getting to market and getting in the hands of a lot more surgeons.

我們仍然認為該產品符合審批條件，而且應該很快就能獲得批准，但接下來還有如何進入醫院的難題需要克服，對吧？通過 VAC 委員會的審批流程以及簽訂合約等事宜都需要時間，這確實需要時間，但是。但我們已經看到醫院方面表現出了濃厚的興趣。我們已經參與了其中的一些項目，人們對重建手術進入市場並被更多外科醫生使用表現出了濃厚的興趣。

Yeah, Alan, just to add to that, as Raj highlighted is, the recon, our expectation is that's where we're going to see the impact in 2027, so we're not really considering that for 2026. And also as you look at preserve, I think we see a tremendous upside in in those in those numbers, and you know I think we've been.

是的，艾倫，補充一點，正如拉傑強調的那樣，偵察方面，我們預計這將在 2027 年產生影響，所以我們並沒有真正考慮 2026 年的影響。而且，當你觀察保護區時，我認為我們看到了這些數字的巨大上升空間，你知道，我認為我們一直都在這樣做。

Very pleased with the initial response not only in the US but outside the US and and I think that has the opportunity for for upside for us in terms of how we drive the business this year.

我對目前的市場反應非常滿意，不僅在美國，而且在美國以外也是如此。我認為這為我們今年的業務發展帶來了成長的機會。

Got it. And then just a quick follow-up on spend, when we look at 2024, we saw a pretty linear increase in spend to support the US launch. This year was a little bit bumpier, talking specifically about SG&A, and it sounds like you've already put in. A good amount of investment into the US Salesforce expansion you previously talked about early on in the year. So just any color on the cadence of, spending on the operating side throughout the year. Should we expect it to be a little bit more front half weighted and then a little maybe improvement in the back half and then maybe next year we see a little bit of a step up to support reconstruction.

知道了。然後，關於支出方面，我們再快速跟進。展望 2024 年，我們看到用於支持美國市場推出的支出呈現相當線性的成長。今年情況有點不順，特別是銷售、一般及行政費用方面，聽起來你已經投入了資金。今年早些時候，您曾提到對美國 Salesforce 擴張計劃進行大量投資。所以，任何顏色都可以用來衡量全年營運方面的支出節奏。我們是否應該預期前半部分會稍微佔優勢，後半部分可能會有所改善，然後明年我們可能會看到重建工作進一步加強？

Thank you so much.

太感謝了。

Yeah, I think your question is a good one. I mean, you look at the overall spending for us, we talked about $195 to $200 million but if 1 x is out non-cash expenses and one-time things, that's $175 to $180 million in cash operating expenses, which compares the number, roughly 160 or so, right? So the increase is well below, the 50+ million dollars of revenue expansion we're going to see this year, right? So we are starting to see the significant leverage in the model playing out. And that's going to continue in 207 and beyond. Even the incremental investment to support the recon market will be well below the opportunity that that represents. And so again, that's another source of leverage for us as it relates to kind of the timing.

是的，我覺得你的問題問得很好。我的意思是，看看我們的整體支出，我們之前討論過 1.95 億至 2 億美元，但如果扣除 1 倍的非現金支出和一次性支出，那麼現金運營支出就是 1.75 億至 1.8 億美元，相比之下，這個數字大約是 1.6 億美元左右，對吧？所以，這一增幅遠低於我們今年將看到的超過 5,000 萬美元的收入成長，對吧？所以我們開始看到該模式的巨大槓桿作用正在發揮作用。這種情況在2007年及以後還會持續。即使是為支持偵察市場而進行的增量投資，也遠低於該市場所代表的機會。所以，這又成為我們在時機掌握上的另一個優勢來源。

It is not linear, right? We do have certain expenses that hit at certain times, as the first quarter will actually likely be a little below trend and then it'll pick up in the back half of the year, but.

它並非線性關係，對吧？我們的確有一些支出會在特定時間發生，因為第一季實際上可能會略低於趨勢水平，然後在下半年會回升，但是。

But we're supporting a lot of the US expansion early on and and then it'll continue to be leveraged over the course of the year, but it's not going to be kind of flat every quarter as you described. It'll be a little up and down with the first quarter perhaps being a little lower and then picking up in the middle part of the year in the back half.

但我們早期會大力支持美國的擴張，然後這種支持會在今年持續下去，但不會像你描述的那樣每季都保持穩定。情況可能會有些起伏，第一季可能會略低一些，然後在年中和下半年回升。

The next question comes from Caitlin Roberts with Koor Annuity. Please proceed.

下一個問題來自 Koor Annuity 的 Caitlin Roberts。請繼續。

Hi, thanks for taking the questions and congrats on all the new rules to all. As it relates to revenue guidance, anything to call out from a seasonality perspective this year, particularly as you ramp further in the US.

您好，感謝您回答問題，也恭喜所有新規生效。就營收預期而言，今年從季節性角度來看，沒有什麼需要特別注意的，尤其是在美國市場進一步擴張的情況下。

So it, it's a good question, right, because the US we do expect is going to continue to grow, right? So sequentially we should be up in the 1st quarter modestly, right? It is a quarter where it's usually a down quarter for the market overall and then you'll see kind of continued step ups every quarter with a very strong finish to the year in the US again following normal seasonality internationally it's a bit more normalized because you're not quite growing the same rate you are in the United States. And so overall, it's going to be that similar pattern where the 1st quarter is down, you see a pickup in the second quarter, it's down a little bit in the 3rd quarter, and we see a very strong finish to the year, but you do have the subtlety of what's happening in the US with the very strong growth we're seeing overall.

所以，這是一個很好的問題，對吧？因為我們預計美國將繼續成長，對吧？所以按順序來說，我們第一季應該會小幅成長，對吧？通常來說，這個季度是市場整體的下行季度，然後你會看到每個季度持續上漲，美國市場在年底會再次強勁收官。這符合正常的季節性法則。國際市場的情況則比較正常，因為其他國家的成長速度不如美國那麼快。因此，總體而言，情況將類似，第一季下降，第二季回升，第三季略有下降，年底將迎來強勁成長，但美國整體成長勢頭強勁，這其中也存在一些微妙之處。

Great, thanks. And then just one more, just how many of your current accounts in the US would you say are high volume accounts and then any color on kind of the average penetration within your accounts?

太好了，謝謝。最後一個問題，您認為您目前在美國的帳戶中有多少是高交易量帳戶？另外，您能否介紹一下這些帳戶的平均滲透率？

Yeah, it's a good question. I mean, when we started, a little over a year ago, we did sign up a lot of high volume larger accounts, a lot of interest in the product, that's broadened out a bit, the 1,500+ accounts we have now kind of span the spectrum of where we are, and I would say, while it's hard to get exact numbers on penetration, we're still quite low in a number of markets, and that's based primarily on the timing of when these accounts came on, right? So. Account that's been with us for 6 months or less, it's going to be lower than one that's been with us for a year.

是的，這是個好問題。我的意思是，一年多前我們剛起步的時候，確實簽了很多大額交易帳戶，大家對產品也很有興趣。現在客戶群擴大了一些，我們目前擁有的 1500 多個帳戶涵蓋了我們業務的各個方面。雖然很難獲得確切的滲透率數字，但我們在許多市場的滲透率仍然很低，這主要是因為這些帳戶的加入時間不同，對吧？所以。在我們這裡開戶 6 個月或以下的帳戶，其費用會低於在我們這裡開戶一年的帳戶。

And so 2026, the story for us is going to be about continuing to expand the number of accounts that we have in the United States, but also going quite a bit deeper into all these accounts and that's that's what's really going to drive the results. There's a lot of potential there. We're still early in a lot of the customers we've signed up over the back half of last year.

因此，2026 年，我們的故事將是繼續擴大我們在美國的客戶數量，但同時也要更深入地了解所有這些客戶，這才是真正推動業績成長的因素。那裡蘊藏著巨大的潛能。對於去年下半年簽約的許多客戶，我們目前仍處於早期階段。

Yeah, Caitlin, just to add, we, that's going to be a big focus for us in 2026. Obviously in the beginning you want to get as many accounts.

是的，凱特琳，補充一點，這將是我們 2026 年的重點工作之一。顯然，一開始你會想要獲得盡可能多的帳號。

And the early adopters, I think we've really seen, strong, push where, Motiva is a majority if not, almost all their volume, it's really now then the next phase is really enhance that penetration and that's a big focus for us. I think there's a lot of, opportunity in that area. I think in certain accounts we're we're underdeveloped now granted that's going to happen over time as they work through their schedules, but as. As Raj noted, this is a key driver for our growth, this year.

我認為我們已經看到早期採用者們強勁的推動力，Motiva 佔據了他們大部分甚至幾乎全部的銷量，現在，下一個階段就是真正提高滲透率，這也是我們關注的重點。我認為那個領域有很多機會。我認為在某些方面，我們現在還不夠完善，當然，隨著他們按計劃行事，這種情況會隨著時間的推移而改變，但是。正如拉傑所指出的，這是我們今年成長的關鍵驅動力。

Awesome thanks so Much.

太棒了，非常感謝！

The next question, Councilor Mason Krikowitz Stevens, please proceed.

下一個問題，議員梅森·克里科維茨·史蒂文斯，請繼續。

Hey guys, thanks for the questions here.

大家好，感謝你們提出的問題。

I guess first, could you just talk about your expectations around China, this year? What are you baking in there? Sorry if I missed it, and really what do you view as kind of the key hurdles, to unlocking that market, whether it be in 2026 or 2027 or, a future year.

首先，您能否談談您對今年中國市場的預期？你在裡面烤什麼？如果我錯過了，請見諒。您認為在 2026 年、2027 年或未來的年份，打開這個市場的關鍵障礙是什麼？

Yeah, thanks.

嗯，謝謝。

As we mentioned in the prepared remarks, and we've really communicated this in the last couple of calls this is a big focus for us, and you know I think the start in China in terms of the distributor building out their commercial capabilities was slower than we would have liked, and we put a lot of focus in that area in terms of around their organization in terms of some of the strategy and targeting different hospitals pricing.

正如我們在準備好的演講稿中提到的，而且我們在最近幾次電話會議中也確實傳達了這一點，這是我們的重點。你知道，我認為在中國，經銷商建立商業能力的起步比我們預期的要慢，因此我們非常關注這一領域，包括圍繞他們的組織制定一些策略，以及針對不同醫院的定價策略。

And you know we've been very pleased over the last 6 months in the back half of the year that we're seeing very good progress in terms of the sellout. So I think a lot of this work is really having an impact and our expectations remain the same. You know this market is a very large market and we expect to have the same type of dominant share in China that we do throughout the rest of Asia.

你知道，在過去的六個月裡，也就是今年下半年，我們非常高興地看到，在售罄方面取得了非常好的進展。所以我認為這些工作確實產生了影響，我們的期望也保持不變。你知道，中國市場是一個非常大的市場，我們預期在中國市場將擁有與我們在亞洲其他地區一樣的主導市場份額。

Got it. Okay.

知道了。好的。

And with the launch of Preserve this year, it seems like ASPs in the USP should benefit. So I guess how much of US growth in 2026 do you really see coming from volume versus ASP expansion, or I guess how do you think about that algorithm, that growth algorithm, even moving into 2027?

隨著今年 Preserve 的推出，USP 中的 ASP 似乎應該會受益。所以我想問的是，您認為 2026 年美國經濟成長有多少來自銷售成長，又有多少來自平均售價擴張？或者說，您如何看待這種成長演算法，甚至展望到 2027 年？

Yeah, I think Mason, we're still so early in the penetration in the United States that the majority of the growth is going to come from continued unit growth, right, if that's that's how you described it, right? So, continue to take share procedure volume that is what's going to drive the revenue. Preservation is certainly going to contribute. We're going to launch it here you know in the 1st quarter very soon, and you know it'll play out over the course of the year, but for us it's still primarily about penetration into this market and taking share. From the incumbents.

是的，梅森，我認為我們目前在美國的滲透率還處於非常早期的階段，因此大部分增長將來自持續的銷售增長，對吧，如果你是這麼描述的，對吧？所以，繼續維持目前的手術量，這才是推動收入成長的關鍵。文物保護肯定會有所幫助。我們很快就會在第一季在這裡推出它，你知道，它會在今年內逐步展開，但對我們來說，主要還是要打入這個市場並搶佔份額。來自現任者。

Got it. Thanks guys.

知道了。謝謝各位。

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

謝謝。今天提問時間就到此為止了。現在我將把電話轉回給彼得·卡爾迪尼，請他作總結發言。

Thank you operator, and thank you everybody for joining the call today. We've made tremendous progress over the last 12 months. I think we're in a very good position to really capitalize, I think, on a unique opportunity and the strengths that we have, especially as around our product and pipeline, so.

謝謝接線生，也謝謝今天參加電話會議的各位。在過去12個月裡，我們取得了巨大的進步。我認為我們處於非常有利的位置，可以真正抓住這個獨特的機會，發揮我們的優勢，尤其是在我們的產品和產品線方面。

Very happy with the progress and really appreciate everybody joining the call today and I look forward to talking to everybody in the in the future.

我對目前的進展非常滿意，非常感謝今天參加電話會議的各位，期待未來能與大家再次交流。

Thank you.

謝謝。

Thank you. This does concludes today's teleconference. You may disconnect your lunch this time.

謝謝。今天的電話會議到此結束。這次你可以斷開午餐連線。

Thank you for your participation and have a great day.

感謝您的參與，祝您有美好的一天。