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. Holder counts are more reliable. Shares outstanding: 29.0m as of 2025-08-06, 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 ≈ $42.64. Options: 6 managers hold calls ($5.3m notional), 5 hold puts ($4.1m).
Trends to Q2 2025
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 |
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 2023 | 52 | 46 |
| Q4 2023 | 54 | 61 |
| Q1 2024 | 76 | 49 |
| Q2 2024 | 69 | 54 |
| Q3 2024 | 68 | 55 |
| Q4 2024 | 69 | 55 |
| Q1 2025 | 78 | 46 |
| Q2 2025 | 77 | 48 |
Calls vs puts
Options held, notional value, last 4 quarters. P/C = puts ÷ calls
Numbers
| Quarter | Calls | Puts | P/C |
|---|---|---|---|
| Q3 2024 | $13.0m | $16.9m | 1.30 |
| Q4 2024 | $66.0m | $27.9m | 0.42 |
| Q1 2025 | $49.4m | $24.2m | 0.49 |
| Q2 2025 | $5.3m | $4.1m | 0.77 |
Biggest buyers
| CenterBook Partners LP | New | +379.4k |
| VIKING GLOBAL INVESTORS LP | New | +343.5k |
| Pier Capital, LLC | New | +252.3k |
| Woodson Capital Management, LP | New | +225.0k |
| Soleus Capital Management, L.P. | New | +211.9k |
| ROYCE & ASSOCIATES LP | Added | +208.0k |
| ROYAL BANK OF CANADA | Added | +176.1k |
| MORGAN STANLEY | Added | +171.7k |
| GARNET EQUITY CAPITAL HOLDINGS, INC. | New | +165.3k |
| Balyasny Asset Management L.P. | Added | +164.8k |
Biggest sellers
| Capital Research Global Investors | Reduced | -920.8k |
| Point72 Asset Management, L.P. | Sold out | -704.8k |
| Polar Capital Holdings Plc | Sold out | -546.5k |
| Vestal Point Capital, LP | Sold out | -433.2k |
| VOYA INVESTMENT MANAGEMENT LLC | Sold out | -417.4k |
| Redmile Group, LLC | Reduced | -198.9k |
| Divisadero Street Capital Management, LP | Reduced | -163.2k |
| BROWN ADVISORY INC | Reduced | -148.0k |
| SUMMIT PARTNERS PUBLIC ASSET MANAGEMENT, LLC | Reduced | -123.8k |
| Assenagon Asset Management S.A. | Reduced | -69.8k |
Biggest calls
| SUSQUEHANNA INTERNATIONAL GROUP, LLP | Reduced | $2.8m65.7k shares |
| CITADEL ADVISORS LLC | Reduced | $1.7m40.5k shares |
| GROUP ONE TRADING LLC | Reduced | $392.9k9.2k shares |
| MILLENNIUM MANAGEMENT LLC | New | $363.0k8.5k shares |
| SIMPLEX TRADING, LLC | Reduced | $46.0k1.1k shares |
| CONCOURSE FINANCIAL GROUP SECURITIES, INC. | Unchanged | $00 shares |
Biggest puts
| SUSQUEHANNA INTERNATIONAL GROUP, LLP | Added | $2.5m59.5k shares |
| CITADEL ADVISORS LLC | Reduced | $1.0m23.8k shares |
| SIMPLEX TRADING, LLC | Added | $503.0k11.8k shares |
| GROUP ONE TRADING LLC | Reduced | $42.7k1.0k shares |
| CONCOURSE FINANCIAL GROUP SECURITIES, INC. | Unchanged | $00 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 in Q2 2025
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 |
|---|---|---|---|---|---|
| Q3 2023 | 1 | $22.5k | 0 | — | — |
| Q4 2023 | 2 | $214.1k | 0 | — | — |
| Q1 2024 | 0 | — | 0 | — | — |
| Q2 2024 | 0 | — | 0 | — | — |
| Q3 2024 | 0 | — | 1 | $677.2k | $677.2k |
| Q4 2024 | 0 | — | 0 | — | — |
| Q1 2025 | 0 | — | 0 | — | — |
| Q2 2025 | 0 | — | 0 | — | — |
None reported in Q2 2025.
Holders, Q2 2025
| Manager | Shares | Change |
|---|---|---|
| JW Asset Management, LLC 65.10% of their portfolio | 3.1m $132.1m | Unchanged |
| RTW INVESTMENTS, LP 1.57% of their portfolio | 2.6m $110.4m | Added +244 |
| BROWN ADVISORY INC 0.12% of their portfolio | 2.1m $91.6m | Reduced -148.0k |
| Nantahala Capital Management, LLC 5.36% of their portfolio | 1.8m $75.8m | Added +1.5k |
| FINDELL CAPITAL MANAGEMENT LLC 28.87% of their portfolio | 1.4m $58.9m | Reduced -5.0k |
| Tyro Capital Management LLC 17.87% of their portfolio | 1.1m $45.6m | Added +2.8k |
| Capital Research Global Investors 0.01% of their portfolio | 1.0m $43.8m | Reduced -920.8k |
| BAMCO INC /NY/ 0.11% of their portfolio | 907.5k $38.8m | Added +160.8k |
| WILLIAM BLAIR INVESTMENT MANAGEMENT, LLC 0.10% of their portfolio | 865.2k $37.0m | Added +17.9k |
| MORGAN STANLEY 0.00% of their portfolio | 844.9k $36.1m | Added +171.7k |
| RICE HALL JAMES & ASSOCIATES, LLC 1.93% of their portfolio | 837.7k $35.8m | Added +10.3k |
| Mudita Advisors LLP 8.61% of their portfolio | 600.7k $25.7m | Added +121.3k |
| TORONTO DOMINION BANK 0.05% of their portfolio | 540.0k $23.1m | Unchanged |
| BOOTHBAY FUND MANAGEMENT, LLC 0.70% of their portfolio | 537.5k $23.0m | Added +9.2k |
| Balyasny Asset Management L.P. 0.05% of their portfolio | 488.7k $20.9m | Added +164.8k |
| First Light Asset Management, LLC 2.31% of their portfolio | 417.2k $17.8m | Added +80.3k |
| ROYCE & ASSOCIATES LP 0.18% of their portfolio | 400.5k $17.1m | Added +208.0k |
| CenterBook Partners LP 0.90% of their portfolio | 379.4k $16.2m | New |
| JPMORGAN CHASE & CO 0.00% of their portfolio | 373.1k $15.9m | Added +5.9k |
| VIKING GLOBAL INVESTORS LP 0.04% of their portfolio | 343.5k $14.7m | New |
| Affinity Asset Advisors, LLC 2.11% of their portfolio | 334.9k $14.3m | Added +54.9k |
| Nuveen, LLC 0.00% of their portfolio | 300.3k $12.8m | Reduced -19.6k |
| Pier Capital, LLC 1.64% of their portfolio | 252.3k $10.8m | New |
| KORNITZER CAPITAL MANAGEMENT INC /KS 0.21% of their portfolio | 246.1k $10.5m | Unchanged |
| Granite Investment Partners, LLC 0.49% of their portfolio | 232.7k $9.9m | Added +15.5k |
| SUMMIT PARTNERS PUBLIC ASSET MANAGEMENT, LLC 0.38% of their portfolio | 229.9k $9.8m | Reduced -123.8k |
| Woodson Capital Management, LP 1.72% of their portfolio | 225.0k $9.6m | New |
| Soleus Capital Management, L.P. 0.63% of their portfolio | 211.9k $9.1m | New |
| RAYMOND JAMES FINANCIAL INC 0.00% of their portfolio | 186.5k $8.0m | Added +66.8k |
| ROYAL BANK OF CANADA 0.00% of their portfolio | 177.1k $7.6m | Added +176.1k |
| Union Square Park Capital Management, LLC 6.33% of their portfolio | 170.0k $7.3m | Added +55.0k |
| STATE OF WISCONSIN INVESTMENT BOARD 0.02% of their portfolio | 168.3k $7.2m | Reduced -755 |
| GARNET EQUITY CAPITAL HOLDINGS, INC. 3.27% of their portfolio | 165.3k $7.1m | New |
| Divisadero Street Capital Management, LP 0.42% of their portfolio | 147.9k $6.3m | Reduced -163.2k |
| D. E. Shaw & Co., Inc. 0.01% of their portfolio | 138.4k $5.9m | New |
| Redmile Group, LLC 0.62% of their portfolio | 136.5k $5.8m | Reduced -198.9k |
| Portolan Capital Management, LLC 0.33% of their portfolio | 124.4k $5.3m | Added +23.6k |
| UBS Group AG 0.00% of their portfolio | 121.5k $5.2m | Added +32.3k |
| BNP PARIBAS FINANCIAL MARKETS 0.00% of their portfolio | 116.6k $5.0m | Added +66.7k |
| NORTHERN TRUST CORP 0.00% of their portfolio | 107.9k $4.6m | Reduced -3.9k |
| GOLDMAN SACHS GROUP INC 0.00% of their portfolio | 106.4k $4.5m | Added +22.0k |
| GMT Capital Corp 0.18% of their portfolio | 98.8k $4.2m | New |
| BANK OF AMERICA CORP /DE/ 0.00% of their portfolio | 97.9k $4.2m | Added +48.6k |
| PRINCIPAL FINANCIAL GROUP INC 0.00% of their portfolio | 97.6k $4.2m | New |
| BlackRock, Inc. 0.00% of their portfolio | 94.6k $4.0m | Added +1.5k |
| PURA VIDA INVESTMENTS, LLC 11.56% of their portfolio | 89.9k $1.9m | Added +44.9k |
| UBS AM, a distinct business unit of UBS ASSET MANAGEMENT AMERICAS LLC 0.00% of their portfolio | 81.9k $3.5m | Added +24.7k |
| VANGUARD GROUP INC 0.00% of their portfolio | 80.9k $3.5m | Reduced -396 |
| Tejara Capital Ltd 1.55% of their portfolio | 78.1k $3.3m | Added +21.9k |
| Assenagon Asset Management S.A. 0.01% of their portfolio | 77.2k $3.3m | Reduced -69.8k |
| 4D Advisors, LLC 1.49% of their portfolio | 65.0k $2.8m | New |
| DISCOVERY CAPITAL MANAGEMENT, LLC / CT 0.22% of their portfolio | 64.4k $2.8m | Unchanged |
| AMERIPRISE FINANCIAL INC 0.00% of their portfolio | 56.3k $2.4m | Reduced -22.8k |
| Hood River Capital Management LLC 0.03% of their portfolio | 53.1k $2.3m | Added +30.8k |
| STATE STREET CORP 0.00% of their portfolio | 50.8k $2.2m | Added +7 |
| Guided Capital Wealth Management, LLC 1.64% of their portfolio | 49.7k $2.1m | Added +5.8k |
| CITADEL ADVISORS LLC 0.00% of their portfolio | 49.0k $2.1m | Reduced -26.1k |
| SEI INVESTMENTS CO 0.00% of their portfolio | 48.4k $2.1m | Added +703 |
| Diametric Capital, LP 1.02% of their portfolio | 44.7k $1.9m | Added +8.3k |
| Strategic Wealth Partners, Ltd. 0.15% of their portfolio | 43.9k $1.9m | First filing |
| NorthRock Partners, LLC 0.05% of their portfolio | 42.9k $1.8m | Unchanged |
| FEDERATED HERMES, INC. 0.00% of their portfolio | 40.5k $1.7m | Reduced -1.4k |
| KENNEDY CAPITAL MANAGEMENT LLC 0.04% of their portfolio | 39.7k $1.7m | Reduced -2.7k |
| Swiss National Bank 0.00% of their portfolio | 39.0k $1.7m | Unchanged |
| ExodusPoint Capital Management, LP 0.02% of their portfolio | 37.6k $1.6m | Added +28.9k |
| GSA CAPITAL PARTNERS LLP 0.10% of their portfolio | 31.8k $1.4m | New |
| Sofinnova Investments, Inc. 0.08% of their portfolio | 28.1k $1.2m | Reduced -555 |
| GEODE CAPITAL MANAGEMENT, LLC 0.00% of their portfolio | 25.9k $1.1m | Added +299 |
| NEW YORK STATE COMMON RETIREMENT FUND 0.00% of their portfolio | 25.3k $1.1m | Added +3.4k |
| ADAR1 Capital Management, LLC 0.17% of their portfolio | 25.0k $1.1m | Added +17.0k |
| STABLEFORD CAPITAL II LLC 0.39% of their portfolio | 24.5k $1.0m | Reduced -349 |
| SIT INVESTMENT ASSOCIATES INC 0.02% of their portfolio | 21.6k $923.0k | Unchanged |
| Legal & General Group Plc 0.00% of their portfolio | 20.8k $887.4k | Unchanged |
| BigSur Wealth Management LLC 0.22% of their portfolio | 20.0k $853.4k | Unchanged |
| Aquatic Capital Management LLC 0.02% of their portfolio | 18.3k $781.4k | New |
| PRELUDE CAPITAL MANAGEMENT, LLC 0.07% of their portfolio | 17.5k $747.2k | Added +3.3k |
| Roehl & Yi Investment Advisors, LLC 0.38% of their portfolio | 17.1k $732.3k | Unchanged |
| CALIFORNIA STATE TEACHERS RETIREMENT SYSTEM 0.00% of their portfolio | 16.9k $720.1k | Unchanged |
| AQR CAPITAL MANAGEMENT LLC 0.00% of their portfolio | 16.7k $712.4k | New |
| Nebula Research & Development LLC 0.06% of their portfolio | 16.2k $692.5k | Added +3.5k |
| WINTON GROUP Ltd 0.03% of their portfolio | 15.2k $651.3k | New |
| CI INVESTMENTS INC. 0.00% of their portfolio | 15.0k $641.0k | Reduced -4.5k |
| Exome Asset Management LLC 0.48% of their portfolio | 13.1k $559.5k | Unchanged |
| MILESTONE ASSET MANAGEMENT, LLC 0.11% of their portfolio | 12.2k $522.6k | New |
| SkyView Investment Advisors, LLC 0.07% of their portfolio | 11.0k $470.0k | Unchanged |
| Pathstone Holdings, LLC 0.00% of their portfolio | 10.1k $433.3k | Added +3.8k |
| Ensign Peak Advisors, Inc 0.00% of their portfolio | 10.0k $426.0k | Reduced -250 |
| Legato Capital Management LLC 0.05% of their portfolio | 9.0k $384.1k | Reduced -148 |
| SG Americas Securities, LLC 0.00% of their portfolio | 8.7k $372.0k | Added +4.2k |
| JANUS HENDERSON GROUP PLC 0.00% of their portfolio | 8.4k $358.4k | Unchanged |
| Handelsbanken Fonder AB 0.00% of their portfolio | 8.2k $350.0k | Unchanged |
| HighTower Advisors, LLC 0.00% of their portfolio | 7.8k $333.0k | Reduced -840 |
| Stonepine Capital Management, LLC 0.29% of their portfolio | 7.0k $299.0k | Reduced -67.5k |
| ARS Investment Partners, LLC 0.02% of their portfolio | 6.5k $277.6k | New |
| MARSHALL WACE, LLP 0.00% of their portfolio | 6.2k $265.3k | Reduced -5.1k |
| Patriot Financial Group Insurance Agency, LLC 0.03% of their portfolio | 6.0k $257.3k | Added +300 |
| ARIZONA STATE RETIREMENT SYSTEM 0.00% of their portfolio | 5.9k $252.2k | Added +148 |
| WELLS FARGO & COMPANY/MN 0.00% of their portfolio | 5.7k $241.6k | Reduced -34 |
| ELEVATION POINT WEALTH PARTNERS, LLC 0.02% of their portfolio | 5.1k $219.0k | Added +64 |
| Private Advisor Group, LLC 0.00% of their portfolio | 4.8k $203.9k | New |