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Establishment ● Labs Coyol Free Zone & Business Park Building , 4th Street , Building B - 15 , Alajuela , COSTA RICA PRESS RELEASE 1187 Coast Village Road , Suite 1-402 , Santa Barbara CA 93108 , USA Investor / Media Contact : Raj Denhoy 415 828-1044 rdenhoy@establishmentlabs.com Establishment Labs Reports Third Quarter 2021 Financial Results and Raises Full Year Guidance SANTA BARBARA , Calif . , Nov 9 , 2021 -- Establishment Labs Holdings Inc. ( NASDAQ : ESTA ) , a global medical technology company dedicated to improving women's health and wellness , principally in breast aesthetics and reconstruction , today announced its financial results for the third quarter ended September 30 , 2021 and provided updated 2021 guidance . Third Quarter Highlights and Outlook EXHIBIT 99.1 Third quarter worldwide sales of $ 29.0 million , an increase of 27.6 % year - over - year . 2021 guidance increased to a new range of $ 124 million to $ 128 million , an increase of 46 % to 51 % over 2020 ; previous 2021 guidance range was $ 122 million to $ 126 million . Cash balance of $ 64.6 million as of September 30 , 2021 . Launched Motiva Flora® tissue expander in Europe and CE mark countries at London Breast Meeting . Motiva JOY® and Motiva MIA® development and commercialization plans progressing as planned . Timelines for US and China market entry remain unchanged . Gross profit for the third quarter was 67.6 % of revenue , compared to 66.6 % of revenue for the same period in 2020 . Third quarter operating expenses of $ 28.7 million , an increase of 61.6 % compared to the third quarter of 2020 as spending returned to more normalized levels following the global disruption in 2020 . " The momentum we have seen across all areas of our business in 2021 continued in the third quarter , " said Juan José Chacón - Quirós , Chief Executive Officer . " Third quarter revenue of $ 29.0 million was up 27.6 % from the third quarter of 2020 and we are raising full year 2021 revenue guidance to a new range of $ 124 million to $ 128 million . " " Our strong financial results are being matched by the significant progress we are making across a number of programs and initiatives , " Mr. Chacón - Quirós continued . " We launched our Motiva Flora tissue expander at the London Breast Meeting during the third quarter . This is an important step in our Aesthetic BreastRecon Ⓡ program , where we are working to expand awareness and access of post - mastectomy reconstruction while offering the tools and techniques that allow women to receive reconstructive surgeries that achieve the aesthetic ideals to which they aspire . " " In addition , our JOY and MIA programs are progressing . These advances are not only opening up significant new markets , they are also allowing us to have a more direct relationship with women on their journey with Motiva . Our regulatory and commercial timelines to begin selling Motiva implants in the U.S. and Chinese markets are also progressing as planned . We remain on a clear path to becoming the leader in breast aesthetics and reconstruction , and to expand these markets as we offer safe , differentiated , and accessible solutions to women . " Third Quarter 2021 Financial Results Total revenue for the quarter ended September 30 , 2021 was $ 29.0 million compared to $ 22.8 million for the same period in 2020. Direct sales comprised approximately 41 % of total sales , while distributor sales made up the balance .