We're Bullish On US Recon Opportunity; FDA Approval On Tap For Late 26/Early 27

Research evidence excerpt

We're Bullish On US Recon Opportunity; FDA Approval On Tap For Late 26/Early 27

TD Cowen Establishment Labs

Global Research June 8, 2026

We Remain Bullish on ESTA's Ability to Win Share in the Large U.S. Reconstruction

Opportunity

U.S. reconstruction represents a massive durable growth driver for ESTA with the $275-350M

TAM (see figure 1), effectively doubling ESTA's U.S. opportunity. Entry into the U.S.

reconstruction market will also give ESTA exposure to reimbursed procedures, which should

further contribute to the company's ongoing shift towards premium-priced procedures (current

tailwinds include growing U.S. mix and minimally invasive offering mix).

The launch of Motiva was able to garner 20%+ share in the U.S. augmentation opportunity

through the first 15 months of rollout, and management has put out a long-term target to

exceed a 50% share position in the long run. We believe the company will replicate this success

in the reconstruction market with Motiva's softer feel, lower wrinkling, lower concern around

capsular contracture, and greater flexibility in pocket selection/prepectoral optionality all

acting as drivers of physician interest. We also view the MRI compatibility of ESTA's Flora Tissue

Expander as a potential enhancer of oncologic workflows. All in all, we expect reconstruction

to become a growth driver in 2027 that strengthens in 2028 as Motiva wins market share for

largely the same reasons as it has in augmentation. Motiva/Ergonomix will slot under the same

reimbursement as existing offerings and therefore while premium pricing to competitors may

not be as high as it is for augmentation procedures it will be more easily absorbed.

Figure 1: U.S. Reconstruction TAM

US Reconstruction TAM

Annual Implant-based Recon Procedures 100,000 100,000