Good afternoon. Welcome to Establishment Labs’ Fourth Quarter and Full Year 2018 Earnings Call. At this time, all participants will be on mute. At the end of this call, we will open the lines for a question-and-answer session and instructions will follow at that time. [Operator Instructions] As a reminder, this conference call may be recorded. I would now like to turn the call over to Kaitlyn Rawlett from Weber Shandwick. Please go ahead.

Thank you, operator and thank you everyone for participating on today's call. Joining me from the Company includes Juan José Chacón-Quirós, Founder and Chief Executive Officer; and Renee Gaeta, Chief Financial Officer. Before we begin, I would like to caution listeners that comments made by management during this call will include forward-looking statements within the meaning of the federal securities laws. These include statements on the Company's financial outlook and the Company's plans and timing for product development and sales. These forward-looking statements involve material risks and uncertainties and the Company's actual results may differ materially. For a discussion of risk factors, I encourage you to visit the Company's annual report on Form 10-K, which will be filed later today with the SEC. The content of this conference call contains time-sensitive information accurate only as of the date of this live broadcast March 20, 2019. Except as required by law, the Company undertakes no obligation to revise or otherwise update any statement to reflect events or circumstances after the date of this call. With that being said, it is my pleasure to turn the call over to the Company's Founder and Chief Executive Officer, Juan José Chacón-Quirós. Juan José Chacón-Quirós: Thank you, Kaitlyn, and good afternoon, everyone. I am pleased to report a strong fourth quarter and an outstanding finish to our first year as a publicly traded company. We ended 2018 with $61.2 million in sales, a 76.5% increase when compared to 2017. Our fourth quarter sales were $16.4 million, a 38.8% increase compared to the fourth quarter of 2017. Our success continues to be driven primarily by the adoption of our Motiva Implants across all markets, which were differentiated science and improved safety outcomes. In 2018, we continued to invest in our business to ensure growth for many…

Thank you, Juan José, and I'd like to thank you all again for joining us on the call today. As Juan José stated earlier, we are very proud of our accomplishments in 2018 and it is a pleasure to cap off the year with another strong quarter. You can find additional details on our fourth quarter and our full-year 2018 financials in our earnings press release and our Form 10-K, which we plan to file later today. Our total revenues for the fourth quarter were 16.4 million, which represents a 38.8% increase when compared to the fourth quarter in 2017. Total revenues for the year ending December 31, 2018, were 61.2 million, representing a 76.5% increase when compared to the same period in 2017. The growth in the fourth quarter was primarily due to the continued volume growth across all of our addressable markets, alongside the improved average selling price driven by our direct market strategies in Europe and Brazil. We are extremely pleased with our sales growth in 2018 and we are confident in our ability to continue capturing additional market share in 2019 and beyond. We remind investors that we are still a very young company and future results can fluctuate quarter-to-quarter as we manage our global footprint, entering new markets and make enhancements to our business model. Gross profit for the fourth quarter was 9.9 million or 60.2% of revenues, as compared to gross profit of 6.6 million or 55.6% of revenues in the fourth quarter of 2017. Gross profit for the year ended December 31, 2018, was 36.1 million or 59% of revenues, as compared to gross profit of 17.7 million or 51% of revenues for the same period in 2017. The increase in gross margin in the fourth quarter and the year ended December 31,…

[Operator Instructions] Our first question comes from Raj Denhoy of Jefferies.

I could start with you Renee, just on the guidance, the commentary on the guidance there at the end. I appreciate the thinking behind not giving more specific guidance, but as I'm sure you know, the spread in the analyst -- our estimates for next year are quite broad, below 20% or I think north of 30% in terms of what you guys could do for growth on the top line, and so I don’t know if you had just any additional thoughts on where you're more comfortable, at the higher end of where we're shaking out or perhaps the lower end, just anything more helpful would be helpful.

Yes, Raj, I appreciate that. Yes, we're definitely focused on the consensus of sort of the average of the numbers. I fully appreciate that that's a decent range at this point in time, but we're definitely comfortable with that right now.

Okay. So, the midpoint is where you guys are good.

Correct.

Okay. And maybe Juan José, can I ask you a couple of questions about the dynamics in the marketplace currently? There's been a lot of activity, as we're all aware, with Europe removing heavily textured breast implants and the US now -- the FDA seeming to have a little bit more focus on breast implants safety. So, a couple levels to the question, I'm curious what you're seeing from a competitive standpoint, are you seeing a lot of increase from competitive or previously competitive accounts or surgeons wanting to talk to you guys now or is it creating an opening for you? And then the second question is really -- is there any risk around this? Have you seen anything in the marketplace that would suggest that women are perhaps rethinking getting breast augmentation given all this -- the enhanced scrutiny around the procedure? Juan José Chacón-Quirós: Thank you, Raj. No, and I think that's the big question. We have and we see an opportunity to capture a competitive market share and introduce our differentiated implants in all markets. We are seeing an influx of new inquiries in all of the direct markets where we can monitor this directly. One important thing to say around that is that because of the amount of countries where we are now directly involved, we are monitoring the potential for patients postponing their surgeries or, let alone, cancel them. But until now, we have not seen that. So, we will remain watchful over those dynamics, but to date we have not seen any reduction in the potential number of procedures.

Okay, that's helpful. Maybe sorry, just one last one for you Renee, and then I'll hop off, but, I was curious about the acquisition of your distributors in Germany and Spain towards the end of last year. How much has that contributed? And as you think about the numbers here for 2019, how much does that add to the revenue base?

Yes, that's a good question, Raj, and some of the acquisitions, all three of them that we had in the fourth quarter, a couple of them happened later in the quarter. So, they didn't actually have a substantial impact into Q4 of '18. We're obviously working through setting up the subsidiaries and working through that dynamic. So, not a significant contribution. So, we're expecting to see the majority of that contribution really start in 2019 and pull forward.

And you haven't quantified that for us, have you in terms of what that could be?

No, I haven't.

[Operator Instructions] Our next question comes from Josh Jennings of Cowen.

Hi. Good afternoon. Thank you and congratulations on a strong end to the year. I was hoping to ask two questions about the pipeline that you mentioned in the prepared remarks and the press release about submitting CE Mark for smooth anatomical tissue expanders, and the updated version of the Ergonomix for minimally invasive. And just on tissue expanders first, can you talk about the tissue expander market internationally and how big is it? Could you commercialize -- when could you commercialize, it sounds like 2020 is when we could see some impact from commercialization. And how important is it to introduce new tissue expander in this era? Are most tissue expanders on the market today macro textured? And then I have one follow up on the Ergonomix, CE Mark submission. Juan José Chacón-Quirós: Thank you, Josh. I have to tell you that we are super excited of the opportunities that lie ahead for us in the breast reconstruction market. Until now, we've been extremely focused in breast aesthetics and we believe that our differentiated technology, because of the improvement in safety outcomes, can have a very meaningful impact in patients for breast reconstruction. And of course, that tissue expander that has taken us so much work is a testament to our commitment to become an important player in breast reconstruction. So that is a SmoothSilk tissue expander, that surface that we have seen performs so well for patients over the last eight years now in a tissue expander. So what we want to see, of course, is an improvement in the results for patients who are undergoing tissue expansion. At this point, we will not quantify the size of the international market, but I can tell you that the opportunity is important. Most of the products that are out there, and I would say the latest technologies of other companies are textured or macro textured tissue expanders. So, we are hoping to get this product to market as soon as possible, but we are undergoing the process and these days, there is uncertainty on how long these processes take. So, that's why, while we want to be in the market as soon as possible, we think that you will start seeing some of that revenue in 2020.

And then just a quick follow-up on that would be great, to ask my next question. Without a tissue expander currently, is it tough to penetrate the reconstructive portion of the market and with the tissue expander, could you just see significant pull through of Motiva Ergonomix into reconstructive cases? Juan José Chacón-Quirós: Our implants have been used for years in breast reconstruction. It is just that because of not having a tissue expander, we have not been able to provide the full spectrum of possibilities that patients need in breast reconstruction. However, last year, we had presentations from several European surgeons with some of the most prestigious institution in Europe who have been using Motiva Ergonomix and Motiva SmoothSilk Plus implants for years now. And they have presented excellent results with excellent safety outcomes. So we continue to see the opportunities there and now with a tissue expander even more.

Thanks for that. And just a follow up on the Motiva minimally invasive natural technique procedure that you seemed to be talking a bit more about and with the CE Mark submission of the most recent version of Ergonomix, one, can you just help us understand what's changed in Ergonomix and then secondly, any incremental color you can talk about in terms of when we might see the first [indiscernible] procedure being done internationally and then how you plan to roll that procedure out into more countries and regions? Juan José Chacón-Quirós: Thank you. And I have to say that when we launched the Ergonomix implant in 2014, we transformed the options for women worldwide because before that, you had a round implant and then so-called anatomical implant. So this Ergonomix implant has become our best selling product worldwide and now what we are going to do is put into market a second generation of that Ergonomix implant. So, it has improved mechanical properties along side to this SmoothSilk surface that has been proven to reduce capsular contracture and other chronic inflammatory conditions. So, of course, we believe that because of those mechanical properties, it lends itself very well for minimally invasive procedures. So we are, again, super excited to see this new version of that implant in the market as soon as possible. But again, we are counting on the regulatory processes and the current regulatory environment to bring perhaps those potential revenues in 2020.

Thank you. I'm not showing any further questions at this time. I would now like to turn the call back over to Juan José for any further remarks. Juan José Chacón-Quirós: Thank you everyone for joining us on today's earnings call. As always, if you have any follow-up questions, please do not hesitate to reach out. We look forward to speaking with you on our next earnings call. Thank you and adios.

Thank you. Ladies and gentlemen, thank you for participating in today’s conference. This does conclude today’s program and you may all disconnect. Everyone, have a wonderful day.