Establishment Labs, one of the 25 most attractive medtech M&A targets, is on the cusp of a big growth spurt, driven in large part by its global Mia Femtech launch.

The Santa Barbara, CA-based company launched Mia Femtech this week in Japan, marking the beginning of a new era in breast aesthetics. Establishment Labs kicked off its global launch of Mia Femtech, a procedure designed to increase breast shape by one to two cup sizes without general anesthesia.

“In 2013, we recognized that traditional breast augmentation was not meeting the needs of most women in Japan. Now, a decade later, we are providing a solution. Our launch of Mia Femtech through our partner clinics is focused on delivering an empowering experience in breast aesthetics that overcomes the reservations women may have while matching the ideals to which they aspire,” said Juan José Chacón-Quirós, founder and CEO at Establishment Labs. “The potential for Mia Femtech in Japan is many times larger than the current breast augmentation market. In creating a solution for Japanese women, we have also created a vibrant new category for women worldwide.”

The Japan launch of Mia Femtech comes on the heels of the company securing new agreements with clinical partners in Europe for the Mia Femtech procedure and a second partner chain in Japan.

Mia Femtech experience is being launched at two clinic chains in Japan. Seishin Plastic and Aesthetic Surgery Clinic operates 10 plastic surgery clinics with Mia Femtech now available at its main Tokyo clinic in Roppongi and at its newest clinic in Ginza. Joe Clinic is a high-end medical aesthetics chain in Japan that will offer Mia Femtech initially at its Tokyo and Osaka locations.

Seishin is a great model for what you will see in the future, because you're talking about the chain of 10 clinics with marketing assets, with a professional staff on the business side that can scale this to the right level. So, we will be looking for partners like Seishin around the world," Chacón-Quirós said during Establishment Labs' second-quarter earnings call in February, according to Seeking Alpha transcripts.

In late March, Establishment Labs announced agreements with four clinic partners in Europe for the Mia Femtech procedure. The first European partners include Nordiska Kliniken in Stockholm, Sweden; Leman Aesthetic Clinic in Geneva; Clinic Utoquai in Zurich, Switzerland; and Clínica Planas in Barcelona, Spain.

Additional centers are expected to be onboarded throughout the year as the company expands the launch throughout Japan and Europe.

In February, Establishment Labs provided 2023 revenue guidance of $200 million to $210 million, which represents growth of 24% to 30% over 2022.

"We continue to view Mia favorably for its short procedure and recovery times, impressive aesthetic and safety outcomes, and significant market opportunity," Marie Thibault, a medtech analyst at BTIG, noted in a March 23 report.

Mia is designed to offer women a minimally invasive procedure that can be performed without general anesthesia in less than 15 minutes with an easy return to daily activities.

The CEO said the company is focused on demonstrating that this is a new category, bringing new women into breast aesthetics, that surgeons are seeing improved efficiency, and that partner clinics benefit from higher economics.

"These proof points will be important as we look to scale Mia into the multibillion-dollar opportunity that it has the potential to become," he said.

Interestingly, Establishment Labs is launching Mia Femtech through a business model without sales reps. Instead, the CEO explained, it's a partnership the company creates with selected clinics that already have good marketing assets that can be mixed with the company's technologies that are embedded into the Mia Femtech procedure.

"So, we are looking to this year as one of the most exciting ones in the history of our company," he said.

Japan is the genesis of Mia Femtech

The CEO also emphasized that Japan is at the genesis of Mia.

"That's where we had the original idea of the need for this type of procedure," Chacón-Quirós said. "And eventually, we realized that there were these type of customers all over the world. So, what we plan to do with Mia this year is to prove that we have new consumers that were not seeking for a traditional breast augmentation. We want to be able to show how these clinics basically scale up, because as we bring Mia out to different geographies, this is the type of information that I think is going to get everyone excited about the market expansion that it can create."

Motiva Flora tissue expander rollout continues

In Establishment Labs' aesthetic breast recon franchise, the rollout of the company's Motiva Flora tissue expander continues. Chacón-Quirós said the market feedback is very positive with more and more surgeons making it their expander of choice in post-mastectomy breast reconstruction.

In November, the company announced regulatory approval for Flora and Motiva implants in Japan, noting that the Japanese market is a significant step in changing the global standard in breast reconstruction.

"What continues to resonate with clinicians globally is that Flora is a much-improved offering with many new advances in what has unfortunately been a neglected category in breast reconstruction," Chacón-Quirós said. "...One in eight women globally will experience breast cancer in her lifetime. But very few of them will undergo a reconstruction as part of their recovery from the disease. As we make progress in our aesthetic breast recon initiatives, the global impact will be meaningful."