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● Establishment ● Labs ● PRESS RELEASE Investor / Media Contact : Raj Denhoy 415 828-1044 Establishment Labs Reports Record First Quarter 2021 Financial Results and Raises Full Year Guidance SANTA BARBARA , Calif . , May 5 , 2021 -- Establishment Labs Holdings Inc. ( NASDAQ : ESTA ) , a medical technology company focused on women's health , initially in the breast aesthetics and reconstruction market , today announced its financial results for the first quarter ended March 31 , 2021 and provided updated 2021 guidance . rdenhoy@establishmentlabs.com First Quarter Highlights and Outlook First quarter worldwide sales of $ 30.3 million , an increase of 24 % year - over - year and a new quarterly record . 2021 guidance increased to a new range of $ 118 million to $ 122 million , an increase of 39 % to 44 % over 2020 ; previous 2021 guidance range was $ 110 million to $ 112 million . EXHIBIT 99.1 First quarter operating expenses of $ 22.2 million , a decrease of 4 % compared to the first quarter of 2020 . Strong cash balance of $ 78.0 million as of March 31 , 2021 . Completed enrollment of one hundred patient Motiva Mia IRB approved study ; filed Motiva Mia tools for CE mark . Commercial launch of Motiva Flora tissue expander in Europe on track . Timelines for US and China market entry remain unchanged . " We delivered record first quarter revenue of $ 30.3 million , which was up 24 % from the first quarter of 2020 and 13 % sequentially from the fourth quarter of 2020 , " said Juan José Chacón - Quirós , Chief Executive Officer . " With our strong first quarter results and continued momentum , we are raising full year 2021 revenue guidance to a new range of $ 1 18 million to $ 122 million , which is an annual growth rate of 39 % to 44 % . " " Our singular focus on women's health and the superior clinical and aesthetic outcomes with Motiva are resonating , " Mr. Chacón - Quirós continued . " We are preparing for the commercial launch of our Motiva Flora tissue expander in Europe this summer , and our regulatory and commercial timelines to begin selling Motiva implants in the U.S. and Chinese markets are progressing as planned . In addition , our initial excitement around Motiva Mia is proving to be justified . We recently completed enrollment of our one hundred patient IRB study in Costa Rica , and feedback from surgeons and women who participated in the case series has been very positive . We believe we are on track not only to become the leader in breast aesthetics and reconstruction , but to expand these markets as we offer safe , differentiated and accessible solutions to women . " First Quarter 2021 Financial Results Total revenue for the quarter ended March 31 , 2021 was $ 30.3 million compared to $ 24.5 million for the same period in 2020. Direct sales comprised approximately 42 % of total sales , while distributor sales made up the balance .