Stock Ratings / Health Care / ESTA / options

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Establishment Labs Holdings Inc. (ESTA) Options Positioning, Max Pain & Unusual Sweeps

$68.41 -0.81% NASDAQ • Live Quote vs Prior Daily Close (Synced Snapshot) EXT / AFTER-HRS: $68.18

Establishment Labs Holdings Inc. (ESTA) carries a Roarable Rating of E (Strong Sell) with 34/100 RQD Confidence due to weak cash-flow efficiency and sensitivity to current interest rates. Wait for business cash flow and institutional buying to improve before committing fresh capital.

📊 Historical Track Record Warning: Scores below 50 (34/100 · E) historically underperformed SPY in 71% of rolling 90-day windows →

ROARABLE E • RED ALERT Cap $2.04B

📤 Share Live RQD Speedometer Card: 𝕏 Post Reddit StockTwits ⬇ Live SVG Card

INTERACTIVE SCENARIO DECK:

🛡️ Portfolio Crash X-Ray

EXT / AFTER-HRS: $68.18 (-0.34%)🧬 Dilution Drag (+2.48% YoY Shares)⚙️ Cash Engine: 5/20 (E) • 0% FCF Margin

Verify 90D Bucket Audit →

📊 Historical Track Record Warning: Scores below 50 (34/100 · E) historically underperformed SPY in 71% of rolling 90-day windows (-8.7% avg 90D alpha vs SPY • 29.0% hit rate).

Audit Bucket Track Record →

RQD QUANT TACHOMETERRED ALERT • E

3-of-3 JEV AI Jury Bearish Warning

Cash

SEC

Whale

Impersonal quantitative research (0–100 RQD rubric) — not individualized investment advice. Past performance does not guarantee future results. Full Disclaimer

5-PILLAR SNOWFLAKE RADARRw E · Rk D-

Each axis scored 0–20

12M PRICE TARGET CONE-10.8% Base Target

WHALE OPTIONS SNAPSHOT: — (No Active Options Snapshot on file for ESTA)Realized 20D OHLCV Swing Band: ±12.5%

Deterministic 5-Pillar Attribution (34/100 Composite)

🔍 WHY ESTA SCORES 34/100 (E) — TOP 3 DRIVERS2 Bullish Pillars + #1 Risk Drag

▲ #1 Bullish Driver: Whale & Options Positioning+11/20 pts (32% of score)

20D Institutional Volume Accumulation (±12.5% realized swing band)

▲ #2 Bullish Driver: SEC 10-K Forensic Risk+8/20 pts (24% of score)

Altman Z-Score 2.52 (WATCH ZONE (1.8–3.0)) • Piotroski F-Score 5/9

▼ #1 Drag / Risk Factor: Insider Conviction & Share Dilution4/20 pts (-16 pt drag)

Dilution Drag (+2.48% YoY Shares) & executive Form 4 sales trim 16 pts from alignment

📈 PAST 4 QUARTERS RQD vs SUBSEQUENT RETURNQ1 → Q2 → Q3 → Current

Q1 (-3Q)

Grade E$61.67-4% Next Q

Q2 (-2Q)

Grade E$59.18+7.8% Next Q

Q3 (-1Q)

Grade E$63.80+7.2% Next Q

Current

Grade E$68.41-8.7% Hist 90D α

Trajectory: E (26) → E (34)Full Audit →

⚔️ ADVERSARIAL OPPOSING CASE & FORENSIC KILL-SWITCH (WHY THE BULL/BEAR THESIS COULD FAIL)CONTRARIAN TURNAROUND & SHORT-SQUEEZE DOSSIER

⚔️ Adversarial Opposing Case: What Could Spark a ESTA Turnaround Squeeze

Gideon Ashmere Forensic Desk →

While ESTA currently carries a cautious 34/100 (E) rating due to Insider Conviction & Share Dilution (4/20), shorts face asymmetric squeeze risk if free cash flow inflects or management executes accretive buybacks.

🚀 Contrarian Squeeze Trigger #1

Established market leader in Health Care with deep daily trading liquidity.

🚀 Contrarian Squeeze Trigger #2

Options & Short-Covering Gamma: Reclaiming the 50-day SMA ($67.06) and Max Pain ($71.83) forces dealer call-delta covering toward $102.47.

🚀 Contrarian Squeeze Trigger #3

Forensic Repair Trigger: Halting share dilution (Dilution Drag (+2.48% YoY Shares)) or retiring high-cost debt immediately upgrades the SEC 10-K Forensic pillar.

🎲 LIVE PREDICTION MARKET ODDS TIED TO $ESTA• $2.4M Crowd Pool • Kalshi / Polymarket Composite

Contract: “ESTA Beats Next Quarter EPS Consensus (Dec 30, 2026) & Holds Above 200D SMA”

YES 34%NO 66%Trade / Inspect Odds →

CALL VS. PUT WHALE SHARE

— (No Active Options Snapshot)

Put/Call Ratio: — (No Active Options Snapshot)

MAX-PAIN EXPIRATION MAGNET

— (No Active Options Snapshot)

No active options chain max-pain snapshot on file

HISTORICAL 20D VOLATILITY SWING

±12.5%

Derived from 20D OHLCV bars (No Active Options Snapshot)

Active Strike Call vs. Put Concentration Ladder (ESTA)

— (No Active Options Snapshot) — No unusual CBOE strike concentration anomalies recorded in the current database snapshot for ESTA.

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ON-DEMAND RQD QUANT WORKSHOP • SPONSORED / PARTNER SPOTLIGHTHosted by Perry Belcher & Roarable Forensic Quant Desk

Red-Light Warning Desk: Spotting SEC Cash-Flow & Dilution Risks Before Downgrades (Featuring ESTA)

✓Walkthrough of ESTA's RQD Radar, SEC cash-conversion gap & downside invalidation levels
✓3 asymmetric Bear/Hedge frameworks when 10-year Treasury yields stay elevated
✓Includes nightly RQD rating-change & forensic signal email alerts on your tracked stocks

RQD INSIDER CLUB WAITLIST$49/YR PLANNED

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ESTA // CANDLESTICK & AUTO-TRENDLINE WORKSTATION6M: -0.32%▲ RESISTANCE BREAKOUT

2026-10-30O $67.38H $68.41L $60.25C $68.41VOL 1.03M

RES: $61.19SUP: $50.38SMA50: $67.06SMA200: $72.38

PRIMARY-SOURCE FORENSICS, SECOND-ORDER LINKS & AI ANALYST DESK

ESTA Dilution Monitor, Expectations Hurdle, Butterfly Connections & Policy Exposure

🦋 ESTA Butterfly Map → + Track ESTA →

Share Count & Dilution Monitor (#25)

Multi-year comparable XBRL diluted share count not disclosed (ETF or recent listing).

Reverse-DCF Expectations Hurdle (#30)

8.0%/yr Implied 5Y Growth

vs. +27.1% actual YoY revenue growth (assuming 9.25% cost of equity & 16.5x terminal multiple).

Ellis Vennor Setup Ledger (#33)

No active Ellis Vennor swing setup published on ESTA today. View full Setup Ledger →

🦋 Documented & Second-Order Butterfly Connections Open Graph →

No direct multi-tier Butterfly edges indexed yet for ESTA. Explore sector supply chains on /butterfly.

AI Analyst Theses, Washington Policy & Company Video

🎬 No recent verified company-specific video clip queued for ESTA today (we never pad ticker pages with unrelated generic clips). Browse Macro Video Desk →

DETERMINISTIC MULTI-FACTOR EQUITY AUDIT • SEC EDGAR XBRL × RQD PEER BENCHMARK

📊 Quantitative Sector Peer Comparison, SEC Filing Delta & Investment FAQ (ESTA)

Health Care Rank #835 of 1016 ⚔️ CDRE vs ESTA Full Matrix →

1. Head-to-Head Health Care Peer Comparison (ESTA vs. CDRE, ENOV, AVR, MSA)

Industry: Industrial Specialties (55 Tracked Issuers)

Across 1016 tracked Health Care securities in the Roarable RQD universe, Establishment Labs Holdings Inc. (ESTA) ranks #835 by composite RQD confidence (34/100, grade E) and #259 by equity capitalization ($2.04B). Within this direct 5-issuer industry benchmark cohort, MSA leads on earnings valuation at 24.8x trailing P/E, while MSA leads on capital efficiency and profitability with 16.6% ROIC and 46.5% gross margin. CDRE currently holds the highest overall quantitative score in the immediate peer group at 74/100 (B) compared with ESTA at 34/100 (E).

Ticker / Company	Roarable Grade	RQD Score	Trailing P/E	Gross Margin	ROIC	1D Change	Market Cap	Head-to-Head
ESTA ACTIVE Establishment Labs Holdings Inc.	E	34/100	—	69.3%	-15.8%	-0.81%	$2.04B	Benchmark Subject
CDRE Cadre Holdings Inc.	B	74/100	30.2x	42.5%	11.0%	+3.81%	$1.33B	/cdre-vs-esta →
ENOV Enovis Corporation	D	46/100	—	59.8%	-32.7%	+4.11%	$1.32B	/enov-vs-esta →
AVR Anteris Technologies Global Corp.	D-	36/100	—	70.3%	-35.0%	+5.25%	$625.9M	/avr-vs-esta →
MSA MSA Safety Incorporated	B	72/100	24.8x	46.5%	16.6%	+1.13%	$6.91B	/msa-vs-esta →

2. Multi-Year SEC XBRL Revenue, Cash Flow & Balance-Sheet Trajectory (FY2023–FY2025)

SEC EDGAR 10-K • FILED 2025-12-31 • CIK 0001688757

In its most recent audited fiscal period (FY2025, filed 2025-12-31), Establishment Labs Holdings Inc. (ESTA) reported GAAP revenue of $211.1M (+27.1% vs. FY2024 revenue of $166.0M , and +27.8% cumulative change since FY2023) , GAAP net income of -$51.1M, operating cash flow of -$50.9M, and free cash flow of -$56.9M (+11.9% YoY). On the balance sheet, ESTA closed FY2025 with $357.2M in total assets against $247.5M in total debt (Altman Z-Score: 2.52, Piotroski F-Score: 5/9).

Fiscal Period	Filing Date	Revenue	Net Income	Operating Cash Flow	Free Cash Flow	Total Assets	Total Debt
FY2025 (FY)	2025-12-31	$211.1M	-$51.1M	-$50.9M	-$56.9M	$357.2M	$247.5M
FY2024 (FY)	2024-12-31	$166.0M	-$84.6M	-$58.5M	-$64.6M	$346.8M	$219.6M
FY2023 (FY)	2023-12-31	$165.2M	-$78.5M	-$88.5M	-$88.5M	—	—

3. ESTA Data-Verified Investor FAQ (RQD Rating, Sector Peers, SEC Forensics & Technicals)

✓ SCHEMA.ORG FAQPAGE JSON-LD ENABLED

Is ESTA stock a Buy, Hold, or Sell right now according to Roarable's RQD model?

As of 2026-11-01, Establishment Labs Holdings Inc. (NASDAQ: ESTA) is rated E (Strong Sell / SELL) by Roarable's 5-pillar RQD engine with a composite confidence score of 34/100 at a spot price of $68.41 (-0.81% 1D, market cap $2.04B). Pillar breakdown: Fundamental Cash Engine 5/20, Institutional 13F & Options Flow 11/20, Executive Insider Alignment 8/20, FRED Macro Regime Fit 7/20, and SEC Balance-Sheet Forensics 3/20. Across 1016 tracked Health Care issuers, ESTA ranks #835 in composite RQD confidence.

How does ESTA compare to CDRE and ENOV in the Health Care sector?

Within the Health Care sector (Industrial Specialties), ESTA carries a Roarable E (34/100 RQD), trailing P/E of N/A, gross margin of 69.3%, and ROIC of -15.8%. By comparison, CDRE (Cadre Holdings Inc.) holds a B grade (74/100 RQD, P/E 30.2x, ROIC 11.0%, cap $1.33B) and ENOV (Enovis Corporation) posts a D grade (46/100 RQD, P/E N/A, ROIC -32.7%, cap $1.32B). Among the 5-stock peer group, MSA leads on earnings multiple (24.8x) while MSA leads on capital efficiency (16.6% ROIC).

What are the biggest fundamental strengths and SEC risk factors for ESTA?

Per ESTA's SEC EDGAR XBRL 10-K filing (FY2025, filed 2025-12-31, CIK 0001688757), Establishment Labs Holdings Inc. generated $211.1M in revenue (+27.1% YoY), -$51.1M in net income, and -$56.9M in free cash flow against $357.2M in total assets and $247.5M in total debt. Key quantitative strengths: Established market leader in Health Care with deep daily trading liquidity.. Primary risk factors monitored: Company executives have done more routine share selling than personal cash buying lately.. Institutional options positioning shows a 50% call / 50% put premium split.

Where is ESTA trading relative to its 50-day, 200-day, and 52-week technical levels?

ESTA last traded at $68.41 (-0.81% on volume of 1,043,253 shares), positioning the stock +2.01% above its 50-day simple moving average ($67.06) and -5.48% below its 200-day simple moving average ($72.38). Across its 52-week range of $47.00 to $97.59, ESTA sits at the 42.3% percentile with a 14-day RSI of 44.9 (NEUTRAL RANGE) and an implied next-earnings move of ±12.5% ($59.86 to $76.96).

ESTA Investor FAQ & Complete 8-Part Research Index

100% OPEN ACCESS • SEC EDGAR × CBOE × FRED

What is ESTA's options positioning and volatility profile?

Roarable tracks verified CBOE unusual options sweeps, put/call ratios, and OHLCV realized volatility bands for ESTA.

Direct Sub-Reports: ESTA RQD Cockpit ESTA 12M Forecast ESTA Earnings & Move ESTA Dividends & DRIP ESTA Insiders & 13F ESTA Whale Options ESTA Profit Sankey ESTA News & Why