ESTAEstablishment Labs Holdings Inc.
Options Analysis Report•ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES
Market Cap $2.1B|NASDAQ
● 2026-05-15$69.80
NEUTRAL
Analysis: 2026-05-14 EOD data
1Y +90.6%YTD +1.4%7D -2.7%
Options Vol
1,684
30D
Implied Move
±8.6%
IV Rank
16%
ESTA Options Overview
IV is elevated with bullish flow. Conditions favor premium sellers.
REWARDS
RISK ANALYSIS
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Value
Is IV priced right?
5.3
ExpensiveCheap
Measures whether options are cheap, fair, or rich relative to historical and peer
IV
levels.Risk Checks3/9 checks passed
IV Rank
≤35%IV Rank 76.6% — elevated vs history
IV/HV Ratio
<1.05xIV/HV 1.21x — IV premium over HV
Sector Relative≤50%
Sector percentile 53% — above sector median
Term Structure
<1.1xFront/Back 0.93x — contango
Skew Normal
<1.25xPut/Call IV 1.16x — elevated
Absolute IV
<80%ATM IV 65.9% — normal range
Spread-Adjusted Value
<80%Effective IV 162.8% (ATM 65.9% + spread 48.5% + bias) — expensive
Execution Efficiency
<3.0%Total drag 69.26% (spread 48.46% + slippage 20.80%) — high friction
Vega Efficiency
≥5.0Vega efficiency 0.30 (vega 1.456 / spread 48.46%) — spread drag
Sentiment
Bullish or bearish?
3.9
BearishBullish
Analyzes
put/call ratios
, open interest skew
, and flow direction to determine market bias.Risk ChecksVery Bearish - Moderate signal (Conviction: -50%, Raw: -24%)
Flow Direction
|net sentiment| ≥25%Conviction-weighted: -50% (strong bearish) — Raw: -24%
OI Skew Magnitude
≥15%|OI skew| 28.2% — put-heavy
Volume-OI Alignment
Same sign, |vol skew| ≥10%Vol skew +100.0%, OI skew -28.2% — divergent (opposite)
Conviction Quality
≥2/3 conditions0-DTE 57%, far-OTM 15%, avg DTE 30
OI Momentum
|change| ≥3%OI change +0.0% (5d) — stable
Smart Money Flow
|weighted flow| ≥20%ITM: +0%, ATM: -52%, OTM: +69% — bearish (ITM/ATM divergent)
Sector Relative≤40% or ≥60%
Sector P/C percentile 50% — neutral vs sector
Activity
Unusual activity?
5.5
QuietActive
Detects volume surges,
block trades
, and unusual options activity that may signal moves.Risk Checks4/9 checks passed
Volume Surge
≥1.5xVolume 1.5x avg — elevated
Turnover Rate
≥15%Vol/OI 5.6% — normal turnover
Strike Concentration
≥60%Top 3 strikes = 50% — dispersed
Multi-Day Persistence
≥2 days2 day(s) elevated — sustained
OI Build
≥5%OI change +0.3% (5d) — stable
Sector Relative≥60%
Sector activity percentile 79% — active vs sector
Trade Quality
≥30%Large trade volume 30% — mixed
Execution Urgency
≥60%Aggressive execution 19% — patient
Flow Conviction
≥30Conviction -50 (bearish) — moderate
Liquidity
Can I trade efficiently?
2.9
IlliquidLiquid
Evaluates
bid-ask spreads
, volume depth, and open interest for trade execution quality.Risk Checks2/8 checks passed
Tradeable Spread
≤5.0%Spread 48.5% — wide
Adequate OI
≥10,000OI 29,881 — adequate
Active Volume
≥500Volume 1,684/day — adequate
Reasonable Cost
≤$0.50$2.42 to cross — expensive
Strike Coverage
≥5 strikes0 liquid strikes — limited options
Sector Relative≤40%
Sector spread percentile 80% — much wider than sector
Order Book Depth
≥100 contractsDepth 75.2 contracts (bid:38.2 ask:37.0) — thin
Execution Quality
<1.0%Avg slippage 20.80% — poor
Timing
Is now a good time?
8.2
RiskyFavorable
Considers earnings proximity,
time decay
, and event calendar for optimal entry timing.Risk Checks8/9 checks passed
Term Structure Clarity
|slope| ≥5%Slope -6.9% — contango
IV Percentile Clarity
<30 or >70IV percentile 77% — seller opportunity
Event Detection
≥10pts kinkIV kink -0.5pts — no clear event
Theta/Vega Clarity
<0.5 or >2.0θ/ν ratio 2.24 — favors income trades
Expiration Distribution
≥3 expirations3 liquid expirations — flexible
Event Risk
≥60% (safe)safe window: No earnings detected
Spread Momentum
<1.2 ratioSpread ratio 1.00x — stable
Flow Momentum
≥25% strength + ≥50% consistencyFlow -50% @ 75% consistency — STRONG directional (bearish)
Smart Money Timing
≥40 composite scoreScore 60 (ITM 20% + inst 30%) — moderate institutional
Directional Strategy Fit
Option Buyers
Long Calls4.9
bullishIV fair, bearish flow
Long Puts5.7
bearishIV fair, bearish flow
Premium Sellers
Cash-Secured Put4.5
bullishIV fair, bearish flow
Covered Call5.3
bearishIV fair, bearish flow
For educational purposes only. Not investment advice.