ESTABLISHMENT LABS HLDGS INC ESTA
COM · Common Stock · CUSIP G31249108
- SectorHealth care
- IndustryOrthopedic, Prosthetic & Surgical Appliances & Supplies
- FilingsSEC EDGAR
* Summed across managers. Shares that two managers' reports both contain – a subsidiary's holdings that its parent's report includes too, or a sub-adviser's in its client's – are counted once ($22.1k this quarter). Holder counts are more reliable. Shares outstanding: 29.8m as of 2026-08-06, from the company's own SEC filing; the percentage can still exceed 100%: lent-out shares are counted by the lender and the buyer, and some reports overlap without saying so. Implied quarter-end price ≈ $85.79. Options: 8 managers hold calls ($27.6m notional), 7 hold puts ($14.7m).
Trends to Q2 2026
Institutional holders
Managers reporting a position, each quarter
Numbers
| Quarter | Holders |
|---|---|
| Q3 2022 | 94 |
| Q4 2022 | 103 |
| Q1 2023 | 112 |
| Q2 2023 | 109 |
| Q3 2023 | 107 |
| Q4 2023 | 100 |
| Q1 2024 | 119 |
| Q2 2024 | 124 |
| Q3 2024 | 131 |
| Q4 2024 | 124 |
| Q1 2025 | 139 |
| Q2 2025 | 141 |
| Q3 2025 | 149 |
| Q4 2025 | 174 |
| Q1 2026 | 176 |
| Q2 2026 | 197 |
Buyers vs sellers
Managers adding to or starting a position, vs cutting or selling out
Numbers
| Quarter | Bought or added | Cut or sold out |
|---|---|---|
| Q3 2024 | 68 | 55 |
| Q4 2024 | 69 | 55 |
| Q1 2025 | 78 | 46 |
| Q2 2025 | 77 | 48 |
| Q3 2025 | 67 | 61 |
| Q4 2025 | 81 | 83 |
| Q1 2026 | 94 | 76 |
| Q2 2026 | 123 | 83 |
Calls vs puts
Options held, notional value, last 4 quarters. P/C = puts ÷ calls
Numbers
| Quarter | Calls | Puts | P/C |
|---|---|---|---|
| Q3 2025 | $7.2m | $2.2m | 0.30 |
| Q4 2025 | $100.5m | $163.2m | 1.62 |
| Q1 2026 | $96.6m | $98.4m | 1.02 |
| Q2 2026 | $27.6m | $14.7m | 0.53 |
Biggest buyers
| PRICE T ROWE ASSOCIATES INC /MD/ | New | +1.5m |
| BlackRock, Inc. | Added | +1.5m |
| Rubric Capital Management LP | New | +688.3k |
| STATE STREET CORP | Added | +410.2k |
| UBS Group AG | Added | +401.3k |
| FRANKLIN RESOURCES INC | Added | +374.5k |
| GEODE CAPITAL MANAGEMENT, LLC | Added | +358.1k |
| Assenagon Asset Management S.A. | Added | +220.5k |
| BANK OF AMERICA CORP /DE/ | Added | +191.2k |
| VANGUARD PORTFOLIO MANAGEMENT LLC | Added | +190.2k |
Biggest sellers
| BAMCO INC /NY/ | Reduced | -678.1k |
| Tyro Capital Management LLC | Reduced | -545.8k |
| GOLDMAN SACHS GROUP INC | Reduced | -465.0k |
| BRAIDWELL LP | Sold out | -463.6k |
| CITADEL ADVISORS LLC | Reduced | -448.4k |
| JW Asset Management, LLC | Reduced | -368.8k |
| MILLENNIUM MANAGEMENT LLC | Sold out | -368.3k |
| JANE STREET GROUP, LLC | Reduced | -266.4k |
| MARSHALL WACE, LLP | Reduced | -226.2k |
| BROWN ADVISORY INC | Reduced | -213.7k |
Biggest calls
| SUSQUEHANNA INTERNATIONAL GROUP, LLP | Reduced | $11.1m129.6k shares |
| CITADEL ADVISORS LLC | Reduced | $7.3m85.5k shares |
| Walleye Trading LLC | Added | $4.1m47.3k shares |
| Caption Management, LLC | Reduced | $2.4m27.9k shares |
| IMC-Chicago, LLC | Reduced | $1.4m16.7k shares |
| JANE STREET GROUP, LLC | Reduced | $738.0k8.6k shares |
| GROUP ONE TRADING LLC | Reduced | $394.7k4.6k shares |
| SIMPLEX TRADING, LLC | Reduced | $103.0k1.2k shares |
Biggest puts
| JANE STREET GROUP, LLC | Added | $5.4m62.5k shares |
| SUSQUEHANNA INTERNATIONAL GROUP, LLP | Reduced | $2.7m31.2k shares |
| Caption Management, LLC | Reduced | $2.4m27.9k shares |
| Walleye Trading LLC | New | $2.4m27.7k shares |
| CITADEL ADVISORS LLC | Reduced | $1.7m20.1k shares |
| SIMPLEX TRADING, LLC | Reduced | $103.0k1.2k shares |
| Walleye Capital LLC | New | $34.3k400 shares |
Options at notional value: the value of the shares the contracts control, as filers report them, not what the options cost. Not included in the holders, shares or buying above.
Major shareholders (over 5%)
Anyone who owns more than 5% of a class of the company's shares has to say so: on Schedule 13D if they may try to influence or control the company, on 13G if they're a passive investor, and update it as the stake changes. Each holder's latest filing, from 19 Dec 2024 on; percentages are of the share class, as the holder worked them out.
| Holder | Stake |
|---|---|
| RTW INVESTMENTS, LP 13G · institution filed 2025-02-14 | 10.0% |
| JW Asset Management, LLC 13G · passive new · filed 2026-07-31 | 9.2% |
| Qatar Investment Authority 13G · passive investor filed 2025-05-13 | 8.3% |
| BlackRock, Inc. 13G · institution new · filed 2026-07-28 | 5.4% |
| BROWN ADVISORY INC 13G · institution -1.6 pts · filed 2026-05-15 | 5.4% |
Fell to 5% or below in the last year: Chacon Quiros Juan Jose (4.9%, 2026-02-19), Nantahala Capital Management, LLC (3.5%, 2026-02-13)
Insider purchases and sales since 1 Apr 2026
Shares bought or sold by the company's own officers, directors and 10% owners, in the open market or privately, as they reported to the SEC on Form 4 (due within two business days of the trade). Grants, option exercises, shares withheld for tax and gifts aren't included.
Officers and directors buying vs selling
Number of people, by quarter (10% owners not included)
Numbers
| Quarter | Buying | Bought | Selling | Sold | Sold under a plan |
|---|---|---|---|---|---|
| Q4 2024 | 0 | — | 0 | — | — |
| Q1 2025 | 0 | — | 0 | — | — |
| Q2 2025 | 0 | — | 0 | — | — |
| Q3 2025 | 2 | $277.6k | 0 | — | — |
| Q4 2025 | 0 | — | 0 | — | — |
| Q1 2026 | 0 | — | 1 | $2.3m | — |
| Q2 2026 | 0 | — | 1 | $20.6m | — |
| Q3 2026 | 0 | — | 0 | — | — |
| Date | Insider | Trade | Value |
|---|---|---|---|
| 2026-05-28 | JW Partners, LP +4 See footnote 3 · See Footnotes | Sold | $4.7m65.1k shares |
| 2026-05-27 | JW Partners, LP +4 See footnote 3 · See Footnotes | Sold | $8.2k113 shares |
| 2026-05-26 | JW Partners, LP +4 See footnote 3 · See Footnotes | Sold | $1.9m25.3k shares |
| 2026-05-21 | JW Partners, LP +4 10% owner · See Footnotes | Sold | $1.2m17.0k shares |
| 2026-05-20 | JW Partners, LP +4 10% owner · See Footnotes | Sold | $252.6k3.6k shares |
| 2026-05-06 | Chacon Quiros Juan Jose Director · See Footnote | Sold | $7.9m105.0k shares |
| 2026-05-06 | JW Partners, LP +4 10% owner · See Footnotes | Sold | $4.5m60.0k shares |
| 2026-05-04 | Chacon Quiros Juan Jose Director · See Footnote | Sold | $546.3k7.8k shares |
| 2026-05-01 | Chacon Quiros Juan Jose Director · See Footnote | Sold | $4.8m67.2k shares |
| 2026-04-27 | Chacon Quiros Juan Jose Director · See Footnote | Sold | $144.4k2.2k shares |
| 2026-04-24 | Chacon Quiros Juan Jose Director · See Footnote | Sold | $2.0m30.2k shares |
| 2026-04-23 | Chacon Quiros Juan Jose Director · See Footnote | Sold | $2.8m42.6k shares |
| 2026-04-14 | Chacon Quiros Juan Jose Director · See Footnote | Sold | $2.4m37.5k shares |
Their holding: how much the trade added to or took from the insider's holding (direct, or the trust or fund named). The same trade is sometimes reported by more than one insider, such as a fund and the director who represents it; totals count it once. A value is left blank where the reported price is far from the market price (usually a typo).
Holders, Q2 2026
| Manager | Shares | Change |
|---|---|---|
| JW Asset Management, LLC 72.24% of their portfolio | 2.7m $231.1m | Reduced -368.8k |
| RTW INVESTMENTS, LP 1.95% of their portfolio | 2.7m $227.9m | Unchanged |
| BlackRock, Inc. 0.00% of their portfolio | 1.6m $135.8m | Added +1.5m |
| PRICE T ROWE ASSOCIATES INC /MD/ 0.01% of their portfolio | 1.5m $131.6m | New |
| BROWN ADVISORY INC 0.17% of their portfolio | 1.3m $112.7m | Reduced -213.7k |
| FINDELL CAPITAL MANAGEMENT LLC 15.50% of their portfolio | 1.1m $94.0m | Added +98.3k |
| Mudita Advisors LLP 12.90% of their portfolio | 723.1k $62.0m | Reduced -41.5k |
| WILLIAM BLAIR INVESTMENT MANAGEMENT, LLC 0.18% of their portfolio | 714.1k $61.3m | Added +25.1k |
| Rubric Capital Management LP 0.54% of their portfolio | 688.3k $59.1m | New |
| Nantahala Capital Management, LLC 1.75% of their portfolio | 671.7k $57.6m | Reduced -161.3k |
| FRANKLIN RESOURCES INC 0.01% of their portfolio | 613.7k $52.7m | Added +374.5k |
| BANK OF AMERICA CORP /DE/ 0.00% of their portfolio | 608.0k $52.2m | Added +191.2k |
| Tyro Capital Management LLC 11.66% of their portfolio | 605.6k $52.0m | Reduced -545.8k |
| D. E. Shaw & Co., Inc. 0.03% of their portfolio | 566.9k $48.6m | Added +159.1k |
| RICE HALL JAMES & ASSOCIATES, LLC 2.34% of their portfolio | 560.9k $48.1m | Added +12.3k |
| UBS Group AG 0.01% of their portfolio | 549.0k $47.1m | Added +401.3k |
| TORONTO DOMINION BANK 0.08% of their portfolio | 540.0k $46.3m | Unchanged |
| SUMMIT PARTNERS PUBLIC ASSET MANAGEMENT, LLC 1.10% of their portfolio | 491.5k $42.2m | Added +98.7k |
| ROYCE & ASSOCIATES LP 0.33% of their portfolio | 472.3k $40.5m | Added +44.8k |
| STATE STREET CORP 0.00% of their portfolio | 455.3k $39.1m | Added +410.2k |
| TWO SIGMA INVESTMENTS, LP 0.03% of their portfolio | 448.4k $38.5m | Added +16.9k |
| GEODE CAPITAL MANAGEMENT, LLC 0.00% of their portfolio | 386.1k $33.1m | Added +358.1k |
| JANE STREET GROUP, LLC 0.02% of their portfolio | 361.3k $31.0m | Reduced -266.4k |
| GILDER GAGNON HOWE & CO LLC 0.30% of their portfolio | 342.0k $29.3m | Added +73.5k |
| Nuveen, LLC 0.01% of their portfolio | 321.5k $27.6m | Reduced -1.2k |
| MORGAN STANLEY 0.00% of their portfolio | 299.3k $25.7m | Reduced -107.0k |
| BAMCO INC /NY/ 0.04% of their portfolio | 286.1k $24.6m | Reduced -678.1k |
| BNP PARIBAS FINANCIAL MARKETS 0.01% of their portfolio | 279.2k $24.0m | Added +72.4k |
| Woodson Capital Management, LP 3.95% of their portfolio | 275.0k $23.6m | Reduced -75.0k |
| Assenagon Asset Management S.A. 0.02% of their portfolio | 271.8k $23.3m | Added +220.5k |
| BOOTHBAY FUND MANAGEMENT, LLC 0.41% of their portfolio | 253.1k $21.7m | Added +21.1k |
| First Light Asset Management, LLC 1.29% of their portfolio | 246.6k $21.2m | Reduced -61.2k |
| VANGUARD PORTFOLIO MANAGEMENT LLC 0.00% of their portfolio | 242.4k $20.8m | Added +190.2k |
| HRT FINANCIAL LP 0.05% of their portfolio | 236.0k $20.2m | Added +127.2k |
| NORTHERN TRUST CORP 0.00% of their portfolio | 235.2k $20.2m | Added +153.3k |
| RAYMOND JAMES FINANCIAL INC 0.00% of their portfolio | 200.7k $17.2m | Reduced -14.9k |
| Capital Research Global Investors 0.00% of their portfolio | 189.0k $16.2m | Added +86.1k |
| ADAR1 Capital Management, LLC 0.75% of their portfolio | 185.6k $15.9m | Reduced -27.9k |
| JPMORGAN CHASE & CO 0.00% of their portfolio | 181.7k $16.0m | Reduced -181.2k |
| Voleon Capital Management LP 0.27% of their portfolio | 173.8k $14.9m | Added +45.1k |
| GARNET EQUITY CAPITAL HOLDINGS, INC. 6.55% of their portfolio | 170.5k $14.6m | Reduced -94.0k |
| GOLDMAN SACHS GROUP INC 0.00% of their portfolio | 167.3k $14.4m | Reduced -465.0k |
| Affinity Asset Advisors, LLC 0.62% of their portfolio | 148.0k $12.7m | Added +48.0k |
| HEALTHCARE OF ONTARIO PENSION PLAN TRUST FUND 0.02% of their portfolio | 145.3k $12.5m | New |
| Granite Investment Partners, LLC 0.63% of their portfolio | 143.5k $12.3m | Reduced -64 |
| Pier Capital, LLC 1.52% of their portfolio | 133.8k $11.5m | Added +243 |
| BARCLAYS PLC 0.00% of their portfolio | 131.9k $11.3m | Added +23.0k |
| Tejara Capital Ltd 4.62% of their portfolio | 131.0k $11.2m | Reduced -177.6k |
| DEUTSCHE BANK AG\ 0.00% of their portfolio | 128.1k $11.0m | Added +26.6k |
| STATE OF WISCONSIN INVESTMENT BOARD 0.02% of their portfolio | 126.0k $10.8m | Reduced -12.6k |
| Hood River Capital Management LLC 0.07% of their portfolio | 117.3k $10.1m | Added +30.1k |
| KORNITZER CAPITAL MANAGEMENT INC /KS 0.21% of their portfolio | 115.5k $9.9m | Reduced -1.1k |
| Divisadero Street Capital Management, LP 0.21% of their portfolio | 106.7k $9.2m | New |
| Union Square Park Capital Management, LLC 6.55% of their portfolio | 105.0k $9.0m | Unchanged |
| CITADEL ADVISORS LLC 0.00% of their portfolio | 100.8k $8.7m | Reduced -448.4k |
| FIRST TRUST ADVISORS LP 0.00% of their portfolio | 99.0k $8.5m | New |
| Trexquant Investment LP 0.05% of their portfolio | 97.8k $8.4m | Reduced -38.1k |
| Redmile Group, LLC 0.51% of their portfolio | 89.0k $7.6m | Reduced -14.5k |
| RENAISSANCE TECHNOLOGIES LLC 0.01% of their portfolio | 82.3k $7.1m | Added +26.5k |
| Walleye Capital LLC 0.03% of their portfolio | 80.1k $6.9m | New |
| Bank of New York Mellon Corp 0.00% of their portfolio | 68.1k $5.8m | New |
| CHARLES SCHWAB INVESTMENT MANAGEMENT INC 0.00% of their portfolio | 65.8k $5.6m | New |
| Simplify Asset Management Inc. 0.07% of their portfolio | 60.5k $5.2m | Added +7.5k |
| Strategic Wealth Partners, Ltd. 0.30% of their portfolio | 56.5k $4.9m | Reduced -1.5k |
| Invesco Ltd. 0.00% of their portfolio | 56.2k $4.8m | New |
| SEI INVESTMENTS CO 0.00% of their portfolio | 51.9k $4.5m | Added +4.6k |
| PURA VIDA INVESTMENTS, LLC 10.44% of their portfolio | 45.0k $3.9m | Unchanged |
| WELLS FARGO & COMPANY/MN 0.00% of their portfolio | 42.7k $3.7m | Added +30.8k |
| Squarepoint Ops LLC 0.01% of their portfolio | 40.8k $3.5m | Reduced -18.8k |
| SummitTX Capital, L.P. 0.09% of their portfolio | 40.4k $3.5m | Reduced -4.5k |
| AQR CAPITAL MANAGEMENT LLC 0.00% of their portfolio | 39.3k $3.4m | Added +6.2k |
| NorthRock Partners, LLC 0.05% of their portfolio | 36.9k $3.2m | Reduced -2.0k |
| Swiss National Bank 0.00% of their portfolio | 36.8k $3.2m | Added +2.6k |
| Jump Financial, LLC 0.03% of their portfolio | 36.1k $3.1m | Reduced -51.9k |
| NEW YORK STATE COMMON RETIREMENT FUND 0.00% of their portfolio | 34.9k $3.0m | Added +9.6k |
| RHUMBLINE ADVISERS 0.00% of their portfolio | 33.1k $2.8m | New |
| Engineers Gate Manager LP 0.04% of their portfolio | 31.5k $2.7m | Added +2.2k |
| ALLIANCEBERNSTEIN L.P. 0.00% of their portfolio | 30.0k $1.7m | New |
| Guided Capital Wealth Management, LLC 1.42% of their portfolio | 28.4k $2.4m | Reduced -6 |
| Dauntless Investment Group, LLC 3.83% of their portfolio | 25.7k $2.2m | Added +16.3k |
| VANGUARD FIDUCIARY TRUST CO 0.00% of their portfolio | 25.6k $2.2m | New |
| ExodusPoint Capital Management, LP 0.02% of their portfolio | 25.5k $2.2m | Reduced -53.6k |
| Buckley Capital Advisors, LLC 1.33% of their portfolio | 25.0k $2.1m | Reduced -69.0k |
| LPL Financial LLC 0.00% of their portfolio | 24.6k $2.1m | Added +2.9k |
| AMERIPRISE FINANCIAL INC 0.00% of their portfolio | 24.3k $2.1m | Reduced -6.9k |
| Qube Research & Technologies Ltd 0.00% of their portfolio | 23.1k $2.0m | Reduced -205.5k |
| POLEN CAPITAL MANAGEMENT LLC 0.02% of their portfolio | 22.5k $1.9m | Reduced -1.8k |
| CALIFORNIA STATE TEACHERS RETIREMENT SYSTEM 0.00% of their portfolio | 22.5k $1.9m | Added +373 |
| SIT INVESTMENT ASSOCIATES INC 0.04% of their portfolio | 21.6k $1.9m | Unchanged |
| Kerrisdale Advisers, LLC 0.44% of their portfolio | 20.4k $1.7m | New |
| ADAGE CAPITAL PARTNERS GP, L.L.C. 0.00% of their portfolio | 18.1k $1.6m | New |
| Legal & General Group Plc 0.00% of their portfolio | 16.8k $1.4m | Added +4.4k |
| XTX Topco Ltd 0.02% of their portfolio | 16.0k $1.4m | Reduced -35.4k |
| MetLife Investment Management, LLC 0.01% of their portfolio | 15.9k $1.4m | New |
| STABLEFORD CAPITAL II LLC 0.46% of their portfolio | 15.4k $1.3m | Reduced -7.0k |
| NewEdge Advisors, LLC 0.00% of their portfolio | 13.9k $1.2m | Added +3.6k |
| AlTi Global, Inc. 0.02% of their portfolio | 13.8k $1.2m | Reduced -996 |
| Headlands Technologies LLC 0.12% of their portfolio | 13.7k $1.2m | New |
| CITIGROUP INC 0.00% of their portfolio | 13.4k $1.2m | Added +5.7k |
| Exome Asset Management LLC 0.69% of their portfolio | 13.1k $1.1m | Unchanged |