Motiva entered Wall Street!

Establishment Labs Becomes The First Costa Rican Company To Go Public On A U.S. Exchange

Today was a big day for Juan José Chacón-Quirós, also known as “JJ.” His company, Establishment Labs, became the first company headquartered in Costa Rica, to go public on an American stock exchange.

Establishment Labs, the first Costa Rican company to go public on a U.S. exchangeESTABLISHMENT LABS

Establishment Labs, now better known by their NASDAQ ticker symbol ESTA, is a global med-tech company in the breast aesthetics and reconstruction market, and the first breast aesthetics IPO in 3 years.

Establishment labs was founded in 2004 but there was a period of searching and benchmarking that occurred before they we market-ready. Chacón-Quirós didn’t happen upon medical innovation by accident. He is the son and brother of a plastic surgeon, his mother is an obstetric nurse and his wife is a doctor.

His family has been a tremendous influence on Chacón-Quirós. He says that “my father taught me everything that existed, and my mother taught me everything that was missing.”

This perspective was significant when it came to doing consumer research related to his innovation, which became the Motiva® implant. Chacón-Quirós found himself focused around consumer needs and what was missing in the market. He wanted to find a way for his innovation to transform the consumer’s initial experience, healing process and ultimate healthcare outcomes.


This morning when Establishment Labs went public, Chacón-Quirós’ mother, father, brothers and close colleagues were all there to celebrate the hard work and the rare accomplishment of going public together.

Nanotechnology, 3D printers and paying customers

Establishment Labs actually became operational in 2008 and enterred the market in 2010. Bigs things happened in the time between 2008 and 2010. For one thing, Chacón-Quirós found an engineer, Salvador Dada Santos, that wanted to do truly innovative things.

Santos left another job in the medical device space, in order to bring reality to life at Establishment Labs. According to Chacón-Quirós, “Santos contributed an ‘engineering mind’ in every sense of the word. He was not only methodical and hardworking but eventually brought in the technicians our company needed to grow.” Among the talent Santos recruited was Roberto De Mezerville, a quality and innovation-minded professional that was critical to the company’s ability to navigate the clinical trial process and achieve their scale plan.

Both Santos and De Mezerville were with Chacón-Quirós this morning when the trading floor opened.

Startup capital versus scale capital & FDA approval

From 2004 to 2008, Chacón-Quirós primarily funded his business by bootstrapping and borrowing money from his family. Eventually, as his research broadened and he became more aware of the full potential of the opportunity, he put together his first seed round.

In addition to developing product, Establishment Labs moved through clinical trials throughout the world and began selling Motiva® and generating revenue. Establishment Labs grew 70% in 2017 in part due to the passion that plastic surgeons expressed relative to the innovative way the product is produced and the potential medical outcomes derived from the biocompatibility of the implant.

Ultimately, Chacón-Quirós knew he wanted to enter the largest market in the world, the United States. But to get the medical technology ready and to prepare for an IPO, transforming the governance, finance and reporting in a way that met NASDAQ’s standards, was a big deal. Three years later, they are ready and Chacón-Quirós says it was worth every minute.

What happens when you make an Initial Public Offering?

According to Chacón-Quirós, today was a very exciting day. The morning began with the first trade ceremony. If you’ve never been on a trading floor, communications begins between the traders on the floor and the lead bankers (in this case Jefferies Financial Group).

Initially, the group on the floor is working to put together a supply and demand scenario. Even those from the Establishment Labs team with economics experience found it hard to understand what was happening until they saw it take hold—and just like that trading had begun.

Breast Cancer & breast reconstruction is a huge, untapped market

Chacón-Quirós feels that the med-tech category, particularly in the aesthetics and breast aesthetics space has been underestimated. Due to this, little innovation has occurred since the 1990s, which puts Establishment Labs in a great position.

Much of their innovation has revolved around creating a cell-friendly surface on breast implants. As Chacón-Quirós describes it, previous methods for manufacturing breast implants relied on secondary processes that introduced additional materials into the surface that can create friction, abrasions and difficulties in healing for patients.

By innovating a production method using nanotechnology and 3D printers to create an exacting surface, Establishment Labs claims to have produced a more biocompatible product, that improves safety and outcomes and has been widely embraced by plastic surgeons around the world.

As they enter the quiet period between a very big day and their first public report of earnings, there is a satisfaction to the silence.

Establishment Labs will use proceeds from the IPO to afford and navigate the FDA clinical trial process. Although they’ve been at work on the paperwork for some time, with today’s IPO, they begin their work in earnest to become the most innovative breast implant and reconstructive product available in the U.S. market.


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