Q1 2025 Establishment Labs Holdings Inc Earnings Call
Speaker Change: Good afternoon and welcome to Establishment Labs, the first quarter of 2025 Ernie Scotland's call. At this time, all participants are in our assembly mode. At the end of the call, we open the line for questions and answers session and instructions will follow at that time.
Speaker Change: As a reminder, today's call is being recorded. I'm now turning over to Raj Denhoy, Chief Financial Officer. Thank you, you may begin.
Speaker Change: Thank you, operator, and thank you, Reverend, for joining us. With me today is Peter Caldini, our Chief Executive Officer, and one of Zane Chacon Quiros, our founder, former CEO and a member of our board of directors. Following our prepared remarks, we'll take your questions.
Speaker Change: Before we begin, I would like to remind you that comments made by management during this call will include forward-looking statements within the meetings of federal securities laws
Speaker Change: These include statements on Establishment Labs Financial Outlook and the company's plans and timing for product development and sales.
Speaker Change: These four-looking statements are based on management's current expectations and involve risks and uncertainties.
Speaker Change: For discussion of the principal risk factors and uncertainties, it may affect our performance or cause actual results of different materially from these statements. I encourage you to view our most recent annual and quarterly reports on Form 10K and Form 10Q, as well as other SAC filings which are available on our website at establishmentlabs.com Thank you very much.
Speaker Change: including but not limited to sales results, which can be stated on a cost and currency basis or profitability of the company's business, which can be stated as EBITDA or just as EBITDA.
Speaker Change: Reconciliation to Comparable GAAP financial Measures for non-GAAP measures , if available, maybe found in today's press release which is available on our website.
Speaker Change: The content of this conference call contains time-sensitive information, accurate only as of the date of this live broadcast May 7th, 2025 Except is required by law, Establishment Labs undertakes no obligation to revise or otherwise update any statement to reflect events or circumstances after the date of this call The content of this call contains time-sensitive information, accurate only as of the date of this call contains time-sensitive information, accurate only as of the date of this call
Speaker Change: With that, it is my pleasure to turn the call over to our founder, Juan Jose J.J.
Speaker Change: Thank you, Raj. Along with our first quarter earnings, we also announced today the appointment of Peter Caldini as permanent CEO of Establishment Labs.
Juan Jose: Since my retirement was announced in January , the Board of Director has undergone an extensive review of potential candidates in following that process, the Board was unanimous in the endorsement of Peter to take the role of CEO . .
Speaker Change: Peter is the right CEO at the right time for our company.
Speaker Change: As a founder and CEO for the past 20 years, I've seen a company evolve from an idea that could revolutionize breast aesthetics and reconstruction by prioritizing science and data to where we are today.
Speaker Change: We've grown that idea to a suite of products and technologies with unmatched clinical performance or products are available globally and we've moved the industry into a new era by making the implants better and safer and by bringing
Speaker Change: The next phase of growth needs a steady hand to help us achieve the financial potential of what we have put into motion.
Speaker Change: As I have said before, I am not going anywhere. I am going to continue to work tirelessly for Establishment Labs in the world that has always been my first love. Working with plastic surgeons to elevate the specialty.
Speaker Change: Strategizing the launch of new products and techniques, supporting our R&D to make even greater strides in advocating for a company to be a leader for women's health. I'm proud of the team at Establishment Labs, and I am excited for Peter to lead our organization in this next chapter of our story.
Speaker Change: With both Peter and Raj, as well as other member of our management team, I look forward to seeing you on June 12th at our investor day in New York City.
Peter, I will turn it over to you [inaudible]
Peter Caldini: Thank you, JJ. I am honored to be taking over as CEO and grateful for your continued support. I look forward to working with you as we continue on the journey that you started two decades ago.
Peter Caldini: I am also pleased to report a strong start to 2025. Revenue in the first quarter totaled 41.4 million
Peter Caldini: Our first quarter sales included $6.2 million from the United States.
Peter Caldini: This was above the 5.5 million we previously guided in late February and reflect the strong adoption that has continued into the second quarter.
Peter Caldini: Outside the United States, First Quarter Sales met our expectations with the markets that it's generally stable to improving.
Peter Caldini: We are reiterating guidance of 205 to 210 million and this does take into consideration the past several months of tariff related impacts.
Peter Caldini: Our guidance is designed to be conservative and we continue to expect our OUS revenue to have single digit growth this year.
Peter Caldini: In the first quarter, we made good progress in leveraging our operating expenses and improving cash flow and continue to forecast our first positive EBITDA quarter in 2025 as well as cash flow break even in 2026.
Peter Caldini: Raj will provide additional details on our results and outlook in a moment.
Peter Caldini: The launch of Motiva in the U.S. continues to exceed our expectations.
Raj Denhoy: As of May 1st, we had over 900 accounts fully on board and over 700 have already placed orders with 84% reordering. Our daily order for the month of April exceeded 120, up from 100 in March.
Raj Denhoy: A couple things to note here. While we felt it was important to provide metrics to allow investors to track our early progress, we were moving towards a more normal cadence, so you should expect updates in line with our quarterly calls.
Raj Denhoy: Also, I would remind you that you cannot calculate monthly or quarterly revenue from our daily order number We generally account for revenue when a doctor uses the device, not when it's ordered.
Raj Denhoy: We provide this information so you can directly appreciate how well our launch is going and appreciate that we are on track for one of the best launches in aesthetic history.
Raj Denhoy: As a company, we are focused on becoming the market share leader in the US.
Raj Denhoy: We are off to a very good start and with our pipeline of innovations making its way through the regulatory process, we expect to be an unparalleled leader for a very long time.
Our engagement with plastic surgeons continues to be very high.
Raj Denhoy: We hosted over 100 US surgeons in Costa Rica in 2024 and will have over 120 attending training events in 2025. We have groups coming down almost every month.
Raj Denhoy: We also have regular master classes in the United States that have had very high interest and attendance.
Raj Denhoy: Surgeon excitement is mirrored by women who are interested or have had augmentation with Motiva.
Raj Denhoy: Perhaps most interesting, numerous plastic surgeons have reported that women coming in for breast revision surgeries covered under competitor warranties have specifically asked to pay for Tiva implants, rather than use free implants covered under their warranty.
Raj Denhoy: The testimonials from women that have had other implants and now have Motiva are compelling.
Raj Denhoy: We continue to see new organic content posted online, including from celebrities and other influencers.
Raj Denhoy: In March, we announced our first sponsored partnership with Meghan Trainor [inaudible]
Raj Denhoy: She mentioned in November on her podcast that she was ready for a breast augmentation after breastfeeding her children and losing weight.
Raj Denhoy: When we were put in touch with her, Megan, in consultation with her plastic surgeon, had already chosen
Speaker Change: She has been an excellent spokesperson for a brand and her experience as resonated with countless women.
Speaker Change: In just a few weeks, there have been over 75 press articles on Megan's Journey with Motiva. The partnership has generated over 4 billion impressions.
Speaker Change: The ROI on this initiative is very clear and we are certainly considering more opportunities.
Speaker Change: It has been notable to see how much this partnership has resonated with the plastic surgeon community.
This is the first A-list celebrity sponsorship.
Speaker Change: In the category, and many surgeons have been enthused that a company is finally focused on increasing awareness after years where the incumbents have done no real innovation and no real marketing specific to breast aesthetics [inaudible]
Speaker Change: Plastic Surgeons have felt left behind for years as the aesthetics industry focused on dermatologist and medspos, perceived as more lucrative group as the establishment lab's sole focus on board-certified plastic surgeons is highly appreciated.
Speaker Change: In reconstruction, our tissue expander is continuing to gain traction and we have completed the back process at more than 60 of the premier cancer centers in the US and we have initiated processes at over a hundred additional hospitals.
Speaker Change: With our recent launch of Preserve in Latin America and Europe , our minimally invasive platform continues to build momentum, both in terms of revenue and changing the industry narrative from a patient and doctor perspective.
Speaker Change: The foundational technology platform behind both MIA FEMPTEC and Preserve allows plastic surgeons to create natural results by preserving the breast anatomy and function.
Speaker Change: We have termed these approaches breast tissue preservation as they both reduce the amount of tissue damage done during the procedure.
Speaker Change: That said, they differ in notable ways in terms of what patients they are designed for.
Speaker Change: Mia is intended for primary augmentations with a 1 to 2 cup size increase with injectable implants.
Speaker Change: It allows for no visible scars on the breast and offers a faster recovery without the use of general anesthesia at top certified centers.
Speaker Change: Mia is a premium offering designed to appeal to the woman who have not been interested in traditional breast augmentation but are using padded or push-up bras. So by definition Mia should be market expanding.
Speaker Change: For 2025, Mia remains on track to achieve 8 to 10 million in revenue we have forecasted.
Speaker Change: Preserve builds on the learnings from Mia and is designed for the day-to-day procedures that make up the majority of breast augmentation cases performed by plastic surgeons.
Speaker Change: It leverages the minimally invasive tools and techniques pioneered with Mia but is more flexible for the surgeon and can be used in a wider cross section of cases and larger sizes.
Speaker Change: It is designed to be the premium choice for women who are already considering breast augmentation surgery and early experience tells us that it may also be market expanding.
Speaker Change: Each step up provides increased value and benefit to patients and surgeons [inaudible]
as well as to us. [inaudible]
with higher price points and gross margin.
Speaker Change: We launch Preserve in Brazil in February and at a select group of countries in Europe in April .
Speaker Change: Most recently, we launched Preservé in the first group of countries in Latin America at the Saps Conference in Columbia.
Speaker Change: The early adoption by Plastic Surgeons is quite promising, and it appears that breast tissue preservation will be a meaningful part of our future growth, and will even contribute to our numbers this year.
Speaker Change: We will continue our roll-out into additional countries and regions over the coming quarters. I will turn the call over to Raj.
Thank you Peter.
Raj Denhoy: Total revenue for the fourth quarter was $41.4 million, and increased 11% from the year-ago period.
Raj Denhoy: Excluding the negative impact of foreign exchange in the quarter, growth would have been 13.5 percent.
Sales from Motiva in the United States were $6.2 million.
Raj Denhoy: There were several items that should be considered in comparing the results this quarter to a year ago. [inaudible]
Raj Denhoy: As we have previously communicated, we generated minimal sales into China in the first quarter [inaudible]
Raj Denhoy: Our distributor purchased approximately $10 million of inventory last year to begin commercial operations and is now selling out that inventory as our procedure share grows.
Raj Denhoy: As demand in the market matches supply, we expect to see additional orders [inaudible]
Raj Denhoy: This is the normal trajectory for a new distributor market, particularly one the sizing of Plexigative China.
Raj Denhoy: Brazil has stabilized with revenue in the first quarter up from the fourth quarter, but we still experienced a meaningful reduction from the first quarter of last year.
Raj Denhoy: Also a note we benefit you from the purchase of our Benilex distributor in the fourth quarter
Raj Denhoy: When factoring these items, revenue growth outside the US was approximately 5% in their first quarter in line with our expectations.
Raj Denhoy: A gross profit for the first quarter was 27.8 million dollars, or 67.2% of revenue, a 160 basis point increase compared to 65.6% of revenue for the same period in 2024.
Raj Denhoy: We expect our gross margin will continue to improve over the course of the year as sales in the United States become a larger part of our business .
Raj Denhoy: We expect to gross profit margins in 2025, but we'll be approximately 200 to 300 basis points higher on an underlying basis compared to 2024 .
Raj Denhoy: As it relates to tariffs, the proposed duties on goods imported from Costa Rica to the United States would represent less than a 50 basis point gross margin impact on a consolidated basis.
Raj Denhoy: and do not change our objective for margin improvements this year.
Raj Denhoy: SGNA expenses of $39.7 million were approximately $10.8 million higher than in the first quarter of 2024.
R&D Expenses for the first quarter were $5.1M.
Raj Denhoy: Total operating expenses for the first quarter increased approximately $11.5 million from the period to $44.8 million.
Raj Denhoy: The increase in operating expenses was due primarily to the ramp up of commercial activity in the United States, following approval of motif implants in late September , as well as the operating expenses in the Benelux of Cidriary we acquired in the fourth quarter.
Raj Denhoy: We continue to expect operating expenses will be approximately 45 to 46 million dollars per
Adjusted if a die was a loss of $12.1 million dollars [inaudible]
Raj Denhoy: Our loss was approximately $1 million lower than the $13.1 million in the fourth quarter.
Raj Denhoy: This was despite the coincially low revenue in the first quarter. We expect to see further improvements into the second quarter and to reach our first EBITDA positive quarter in the second half of this year. Thank you for your time.
Raj Denhoy: Our cash position on March 31st was $69.2 million. We have an additional $25 million still available under our credit facility, putting our total accessible cash balance at approximately $94 million.
Raj Denhoy: Our cash use in the first quarter was $21.2 million. As we noted previously, the fourth quarter of last year and the first quarter of this year should be the highest for us in terms of cash use as we launch in the U.S. Our cash will soon improve, meaning please as we deliver these investments against higher sales expected in the United States over the coming quarters.
Raj Denhoy: We expect to see sequential improvement in our cash loss each quarter of the balance of the year, and we should reach cashflow break even in 2026.
Raj Denhoy: Cashew should come down by approximately $5 million a quarter, each quarter of the course of 2025 as we approach profitability.
Raj Denhoy: Under our current outlook, we expect to get to cash for positive in 2026 without the need for any additional equity races.
Raj Denhoy: A revenue guidance for 2025 remains $205 to $210 million, representing growth of 23 to 26%. We expect to see good sequential growth both in the United States and the U.S. in the second quarter.
Raj Denhoy: We are very mindful of the current dynamics in the global economy and the uncertainty recent trade policies are creating. Our thinking on guidance includes the impact of terrorists has currently proposed.
Raj Denhoy: Importantly to date, we have not seen any impact on demand on demand.
Raj Denhoy: As we have shown in past periods, we will react any slowdown that might develop and will reduce our expense base as needed. We are committed to achieving our revenue, profitability and clash flow targets and are confident in the allegory of promoted.
I'll turn the call back over to Peter.
Thank you, Raj.
Speaker Change: I am excited to be taking over the leadership of Establishment Labs at such a seminal point in our company's history.
Speaker Change: We have now launched our products into the largest and highest value markets in the world.
Speaker Change: We have brought forward a number of significant advances from our minimally invasive platform.
Speaker Change: Both Mia and Preserve continue to make good on the promise of expanding our markets as women are drawn to more natural and safer breast procedures.
Speaker Change: With this as a foundation, we are now tasked with driving efficiency in our organization.
Speaker Change: As we progressed through the year, we are focused on four main priorities.
Speaker Change: The ongoing launch of our minimally invasive portfolio and advancing our innovation pipeline.
We continue to make significant progress in all fronts.
Operator, we are ready to take questions.
Speaker Change: Thank you. We now be conducting a question and answer session. If you'd like to ask a question, please first start one on your telephone keypad. A confirmation tone will indicate your line is on the question key. You may first start two to remove yourself from the key. You may first start two to remove yourself from the key. You may first start two to remove yourself from the key.
Speaker Change: For participants using speaker equipment, it may be necessary to pick up your handset before pressing the start keys. One moment please toy pole for questions.
Speaker Change: First question here is from Marie Thibault, from BTIG, please go ahead
Marie DeBolt: Hi, good afternoon. Thanks for taking the questions and Peter congrats on the official appointment here. Glad to be working with you. Thank you.
Marie DeBolt: I wanted to use my first question here on the OUS Outlook. Definitely appreciate that you've given us this commentary that you haven't seen an impact on demand that bookings are normal. Can you confirm for me the mid-single digit guidance that I think you've talked about in the past and maybe break down consumer sentiment by region where we're particularly interested in hearing about Brazil, Southeast Asia, and China, if you can.
Marie DeBolt: Yeah, thank you. As we highlighted in the...
The beginning of the call is...
Marie DeBolt: We'll continue to drive the business in those markets. As it relates to the different regions, it's very similar to what we've said in the past. Asia is stabilized last year. We're starting to see different areas of growth.
Marie DeBolt: Europe also stabilized in different pockets of growth and I think the one market it.
Marie DeBolt: Or one region where we continue to see some challenges is Latin America. And I think for our business in Brazil, I think we've really stabilized. We're starting to see some growth but the market itself continues to be challenging.
Speaker Change: Okay, that's very helpful. Thank you for that. And then I want to dig in a little bit more on Preserve Congrats on launching that in some countries. You mentioned it could be market expanding. I'd love to hear a little bit more about how that population, you know, how you sort of characterize that implant population, and how it's being...
Speaker Change: Position versus Motiva, and also any timelines you might give us for both Mia and Preserve in the US if you can.
Okay.
Speaker Change: Yeah, so I'll start off with Preserve, so it's actually, we've gotten very strong response, where we rolled it out, an industrial dwarf.
also in Brazil, as well as in Colombia most recently.
Speaker Change: Approach, but it really expands the market opportunity by, you know, continue to have for the day, day to day use. What we are seeing in some of the markets is there's such strong interest.
Speaker Change: that I think we're able to attract more consumers to this area and actually bring in increased market share as well. And then as it relates in terms of time, I'll let JJ add a little bit more to the president and the launch.
Thank you for joining us. Thank you.
Juan Jose: Yeah, I think it's important to realize that, you know, we are currently in the supplement in the United States for, you know, additional sizes to motivas, mutual ground and motivas, mutual ergonomics.
Juan Jose: So, you know, we are working through the additional supplements that we talked about back in January . So, you know, the potential is that one of those supplements, you know, will include, you know, the tools necessary to be able to, you know, perform Mia and eventually, you know, as well as pressurvey in the United States. [inaudible]
Juan Jose: OUS, I think, you know, it's gonna be mostly in select countries in Latin America and Imiya first, and I think, you know, perhaps later this year we'll see some additional markets in Asia-Pacific.
Thank you for joining us. Thank you.
OK, thanks for taking the questions.
Speaker Change: Next question is from Josh Jennings from TD Calend, please go ahead
Josh Jennings: Good afternoon, thanks for taking the questions and Peter congrats on confirmation of the COC, that's great news.
I'm just hoping that just initially touch on...
Josh Jennings: and you call it out, meaningfully exceeding 35 million color guidance that's on the table. Maybe just talk about this strategy, I think it's just conservatism and you've mentioned that, but maybe talk more about the strategy of keeping the guidance where it is, despite the first four months of the year outpacing that range.
Speaker Change: Yeah, so thanks. I mean, as we mentioned, we're very happy with the performance in the US. I mean, it's all the metrics that we laid out. We've been exceeding what we had originally forecast, so we're very pleased with the launch. And I think the real drivers for that is we have a best in class organization.
Speaker Change: We have a superior product, a superior safety profile, and we're also investing...
Speaker Change: in terms of driving the business with the Megan Trainor program. So we see a lot of opportunities to continue to expand that. I think we're going to continue to see sequential growth.
Speaker Change: You know, we're trying to be conservative in terms of how we're managing our guidance, but, you know, all the performance today is exceptionally good and it's exceeding what we had originally thought in terms of when we launched the product.
Speaker Change: I want to just one more question on the US with Thibault launch. Just what are you guys seeing in the field in terms of competitive response? Anything to call out?
Speaker Change: Any competitive pricing or any pipeline products from competitors that are on your radar?
Thank you for taking the questions. Yeah, I mean with-
Speaker Change: Yeah, so I think in terms of the competitor response, we haven't seen anything, I would say significant, you know there's been some pockets of price.
Speaker Change: Price Discounting, but in a lot of cases that's when already the clinic has converted to Motiva, so it hasn't really had an impact, but...
Speaker Change: So far I think the competitive response has not been that significant and we will continue to monitor it and we'll make adjustments if things do change but so far it's been very positive for us.
Appreciate it. Thanks, Peter.
How are we ready for the next question?
Operator, Matthew Taylor
Speaker Change: The next question comes from the line of Mike Matzen with Neededman Company. Please proceed with your question.
Mike Mattson: Yeah, thanks for taking my questions. I guess to start with one on the US sales force, I think you said before, it was around 40 reps. So is that still the case? Let's talk about your plans to expand that this year and next year.
Mike Mattson: Yeah, so, as we mentioned before, we are at 40 reps.
We also highlighted in the previous earnings call, is that...
Mike Mattson: We will be expanding that in certain markets, certainly the larger cities where we've had good penetration, like New York and South Florida. We're going to be adding additional reps throughout the course of the year.
Mike Mattson: As we go into 2026 as a part of our planning process, we're going to continue to evaluate and...
Mike Mattson: and look at increasing the number of reps. You know, certainly we do not have any white spaces, but it's a pretty broad coverage.
Mike Mattson: Also looking at when we look at the innovation coming down the line, making sure we have the right sale support to drive that business into 2026 and beyond.
Speaker Change: Okay, got it, thanks. And then just, you know, Flora, wondering if you could give us some feedback on how things are going in the U.S., what you're doing from surgeons.
Thanks.
Speaker Change: Yeah, so I mean, Flores is going well. Obviously our priority with the launch in the US is around the augmentation with Motiva.
Speaker Change: The major clinics that will help us drive that floor of business, but it really gives us a foundation.
Speaker Change: So once we do get the recon indication that we'll have a good foothold and continue to explain it so that...
Speaker Change: What we're getting in terms of the performance of floor is very positive. You know, clearly we don't have the reconstruction indication, which kind of limits the potential there, but what we're seeing so far has been very positive. [inaudible]
Alan Gong: Let's question some Alan Gong from JP Morgan. Please go ahead
Alan Gong: Thanks for the question. I'm just like starting off at a quick question just on the spend profile, you know, I think
Alan Gong: This corridor, you came in a little bit better than expected, especially on the SJNA Front. You had previously talked to, you know, give or take $45, $46 million of operating spent per quarter. If that's still kind of the right place to be going forward or given, as you mentioned, first quarter, is a little bit, you know, heavily weighted because of the U.S. law and should actually see improvement over the rest of the year.
Alan Gong: Yeah, hi, Owen. That's the way to think about it. So we were a little bit lower in the first quarter, however, you know, there's always some timing questions. So I think modeling at that 45 to $46 million of quarters is a right way to do it.
Alan Gong: You know, and as you build that over the course of the year and you see the revenue particularly driven by the United States doing very well, that's what starts to drive the leverage and allows us to see those EBITDA and cash flow improvements we're expecting over the balance of the year.
Speaker Change: Thanks. And then, I suppose, you know, you reiterated the guide on during the pre-announce, you're kind of reiterating, again, this quarter. It sounds like the language, you know, on the US launch has remained really positive. It's even, you know, getting a little bit more positive this quarter, so I guess, you know, with FX.
Speaker Change: being now potentially a tailwind of the full year in the U.S. launchings. That's a really strong momentum. You know, how should we think about the, I think, you know, kind of the 205 or 210, right? Like, how realistic is it that we could see some upside to that range?
Speaker Change: Yeah, it's, it's a good question, you know, as, as we know it on the call, um,
Speaker Change: Our guidance is intended to be conservative. You know, the Motiva sales of US are tracking to
Speaker Change: Outside of U.S. or expectations are unchanged, we're not seeing any slowdown yet [inaudible]
Speaker Change: We are choosing to be conservative in our outlook clearly. That's really in the year. We just don't see any of this point to raise the guidance. We remain very confident in the outlook we've given.
Speaker Change: I'd offer that in an ordinary environment where there wasn't a lot of concerns around the macroeconomic outlook, we would likely take things up, but there was just a lot of uncertainty at this point, we're just being mindful of that
Mason Carrico: Next question is from Mason Carago from Stevens, please go ahead Thank you very much.
Hey guys, thanks for the questions here.
Mason Carrico: You've previously talked about a halo effect that the FDA approval has had. I think you've called out over 100 new account wins OUS related to it. I'm curious, you just be willing to update us on that dynamic, maybe how it's trended in US and ultimately do you have visibility into
Mason Carrico: The number of OUS clinics that, you know, maybe state that they only utilize FDA-approved products in their practice, just as we kind of think about that opportunity.
Mason Carrico: Yeah, so thank you for the question. I mean in terms of the FDA approval, you know, clearly there's a number of clinics OUS that have communicated that's what was the
Mason Carrico: Driver for their resistance but you know what we're seeing in each of the markets we continue to convert a number of these clinics I don't have the specific number and it's always difficult to know what's the real reason why you
Mason Carrico: They don't confer to our implants, but we're continuing to see strong momentum, especially with all the positive momentum in the U.S.
Mason Carrico: with some of our campaigns and with the surgeons. What they're doing in terms of social media could continue to really expand the opportunity. And we're seeing a lot more of those clinics converting, but the specific number is really difficult to put up.
of the Fangeron.
Speaker Change: Okay, that makes sense. And then could you just talk about the different utilization rates you're seeing from surgeons, and maybe those who are on board it earlier in the launch versus more recently. Any color on the ramp you're seeing once, once new docs get on board it.
Yeah, so I think...
Speaker Change: Use as Motiva or as Accepted Motiva. There's also this consultation period, so it's not always immediate. There is a lag and once they use Motiva, one of the procedures, you start seeing more and more in quicker conversion. We have a number of...
Speaker Change: Accounts that are doing over 100 specific Motiva orders and then some accounts at 50 so we're continuing to see a strong growth.
Speaker Change: As we're in the market and as we start converting more of those clinics and they start using up, you know, Motiva, so it continues to accelerate.
Got it. Thank you.
Speaker Change: The next person is from Joanne Wuensch, from Citibank, please go ahead [inaudible]
Speaker Change: Good afternoon. Thank you for taking the question, and Peter, congratulations.
Thank you.
Speaker Change: I want to make sure that I understand your commentary for 2025. You talked about progressing according to plan. Could you please sort of lay out how we're going to look at this over the next couple of quarters and then
Speaker Change: Use it to jump into 2026, given the turf environment. And then my second question, which I hope is more interesting, for the accounts that are really engaged and really using Motiva and displacing other products.
What are you seeing sort of as a-
Speaker Change: If I can ask, the penetrations of last market share amongst emotive versus autotodics. Thank you.
I'll take the first one, Joanne. Let's go.
Speaker Change: You know, the picture I were behind on the Bruce Margin improvement is the United States, as we've talked about before, the realized price of the US is significantly higher, really for the 2X, where we get outside the United States at this point. So, as that becomes a large portion of art.
Speaker Change: Of our mix, it will pull our gross margin higher if you saw that already in the...
Speaker Change: In the first quarter and two as we progressed to the year and we see the U.S. Pantheiter and Contributor, we'll actually see that gross margin going higher as we've talked about a two to three hundred base points improvement over the course of the year. We're very comfortable to let out hook.
Speaker Change: Has it relates to tariffs? You know, as we commented, the way that we import product into United States, it has a very little impact on our overall consolidated gross margin. There are certain rules as you've seen in the tariffs about excluding US source raw material into your...
Speaker Change: into the value you're exporting into the U.S. ad. So we have a lot of things we can do to offset the impacts of tariffs, and so it's really going to be a very middle impact on our...
Our gross margin to director you over this year and into action [inaudible]
Speaker Change: in terms of the share within that clinic. I think there are in certain situations since we don't have the full metrics, or matrix, we don't have all the sizes, so there's still going to be situations where they're going to be using competitive products. But...
Speaker Change: What we're saying is just almost over time, just close to 100% conversion [inaudible]
Thank you.
Speaker Change: Next questions from Matt Bailer from Jeffries, please go ahead
Matt Beller: Hey, thanks for taking the question. Are you okay?
Yep, yep, we can refine.
Speaker Change: Okay, sorry. So that's a different penetration question. You've talked in the past about some of these other similar markets where over time you've achieved 40 to 70% share.
Matt Beller: over sort of like a five-year period. With your early success here in the US, are you feeling like you could be at the higher end of that range, lower end of the middle, do we not know yet? I'd love for your thoughts on the longer term.
Matt Beller: And so, things are going very well. Ultimately, we'll see where we end up, but we have high hopes to get to a dominant chair and beyond in the United States.
Matt Beller: And just to follow up on that guidance, any different assumptions on Preservea or Mea relative to before?
Sorry Matt, can you repeat the question?
Matt Beller: Yeah, I just wanted for your guidance. Are there any different assumptions or trends that you would call out for Mia or Preservé relative to before?
Matt Beller: No, I think, you know, we talked about eight to ten million dollars from me this year. It's tracking well.
Matt Beller: Preservey, we hadn't included a tremendous amount of that in our guidance, and so far it's doing well. Again, still really there, so we'll see how that develops over the course of the year. But as we've tried to communicate on this call, that so far the business as it through the first quarter is tracking very well. We'll see how that develops over the course of the year, and we'll see how that develops over the course of the year.
Matt Beller: and so the guidance remains where it is and so far things are playing out as we expected.
All right, thanks Rast
Speaker Change: And our next question comes from Anthony Petrone, from the Duho Group, please go ahead [inaudible]
Anthony Petrone: Thanks, congrats on the core here, showing us out to the year, congrats Pete on the appointment and lots of luck heading in here. Maybe one on just the US.
Account Penetration Expectations, obviously adding at a robust rate.
Anthony Petrone: There's intention to add feet on the street. So maybe a recap, again, you know, you're exceeding expectations on the a number of counts open and the reorder rates within those accounts.
Anthony Petrone: But maybe a refresh is the target here to eventually get to the top 2500 plastic surgeon accounts in the United States.
Anthony Petrone: And then how quickly do you think you can get kind of every one where you need to be in terms of reordering within a reasonable time frame and I will have a quick follow up on Mia.
Yeah, so thanks for the question in terms of...
Anthony Petrone: Like we said before, and we keep reiterating the growth and the how we're penetrating the US market is exceeding our expectations.
Anthony Petrone: and in terms of where we expect to see...
Anthony Petrone: We will, as I mentioned before, in terms of sales force. We'll continue to add sales force in the markets where we want to add additional penetration, making sure we get the right coverage. So,
Anthony Petrone: You know, in terms of how we're tracking, it's exactly, you know, not only just what we expected, but it's far exceeding what those expectations were.
The viewpoint there was Permigate Account . . .
Anthony Petrone: You know, you can eventually get up to a million in production at those sites just considering the premium offering and end-to-end sort of solution.
Anthony Petrone: Is that still the same way to think about it? Do you have any of the media accounts on track to meet that, you know, million level per year and contribution? Thanks. Congrats again.
Anthony Petrone: Yeah, so we keep on making progress in terms of the number of accounts we were up to 75 accounts.
Anthony Petrone: We're now in 42 cities in terms of the performance we have two accounts that are actually at a million dollars a month and are progressing very well in it.
Anthony Petrone: It takes time to get there but we continue to see that as a good projection for how we're performing with Mia.
Speaker Change: Great, thank you. This is all the time we have for questions today. Do not have to turn the floor back to Peter Caldini for any closing comments.
Peter Caldini: Yeah, thank you operator. We look forward to seeing everybody at our analyst meeting on June 12th and at the Jeffrey's conference on June 4th and once again thank you everybody for joining the call.
Speaker Change: This concludes today's teleconference. You may disconnect your lines at this time. Thank you again for your participation .