What Management Said
Read the full Q1 2026 transcript ↗These statements may include our future expectations regarding financial results and guidance, market opportunities, and our growth. A reconciliation of these measures can be found in our earnings release as filed this morning and in our most recent 10-K, which is available on our website. For this morning's call, I will start with a review of our first quarter performance, followed by an update on strategic priorities which are driving our return to growth. Michael will then take you through our first quarter financials and 2026 outlook.
We stabilized revenue year-over-year and delivered positive same-center sales for the first time in over two years. We expanded gross margin and made important investments in marketing and talent. We remain confident in our outlook and our ability to deliver sustained long-term profitable growth and value creation for our shareholders. Let me now share highlights of our progress on the strategic priorities that have repositioned our company for sustainable and consistent growth.
Combined with fat removal and fat transfer, these procedures have the potential to unlock more than $100 million in long-term revenue across our existing centers. The marketing initiatives we launched at the end of 2025 are translating into more consistent demand. Through better training, deeper product understanding, and aligned incentives, our teams are converting demand more effectively. As a result, we are seeing improvement in conversion rates and revenue.
What went well
- Delivered positive same-center sales for the first time in over two years, stabilizing revenue year-over-year at $39.4 million (flat vs. prior year, up 1% on a same-store basis excluding London) on higher case volume, a 19% sequential improvement.
- Expanded gross margin by roughly 1 percentage point to 60% of revenue, with cost of services of $15.6 million.
- Strengthened the balance sheet, ending the quarter with $16.7 million in cash and leverage below 2.5x, a reduction of over one turn versus the same time last year.
- Paid down $11 million of debt in the quarter (gross debt of approximately $46 million at quarter end) and nearly $30 million over the last five quarters; cash flow from operations rose to approximately $5 million from about $1 million a year ago.
- Gained early traction on newer procedures, completing over 150 skin excision procedures in Q1, with standalone skin tightening and skin removal targeting the GLP-1 opportunity.
What went wrong
- Adjusted EBITDA declined to $3.3 million, or roughly 8.4% of revenue, down from 9.5% in the prior-year quarter.
- Customer acquisition cost rose to roughly $3,400 per case from $3,130 in the prior-year quarter.
- SG&A increased approximately $800,000 year-over-year to about $22.6 million, reflecting deliberately higher marketing and brand investment.
- The consumer environment remained challenging, especially for considered purchases, and management continues to monitor macro factors such as consumer sentiment.
- New skin removal/skin tightening procedures are still in pilot phase and not yet a meaningful incremental revenue contributor.
Guidance Changes
| Metric | Period | Current guidance |
|---|---|---|
| Full-year 2026 revenue | FY2026 | $151M-$157M (reaffirmed) |
| Full-year 2026 Adjusted EBITDA | FY2026 | $15M-$17M (reaffirmed) |
| Comparable revenue growth (midpoint, ex-London) | FY2026 | approximately 3% |
| De novo center openings | FY2026 | none contemplated in guidance |
| Same-store sales and EBITDA | Q2 2026 | sequential improvement in both revenue and EBITDA in absolute dollars vs. Q1 |
Performance Breakdown
| Metric | YoY | Note |
|---|---|---|
| Revenue | flat at $39.4M (+1% same-store ex-London) | Higher case volume driven by enhanced sales and marketing initiatives; +19% sequentially. |
| Gross margin | +~1 pt to 60% of revenue | Cost of services of $15.6M with improved operating leverage. |
| SG&A | +~$800K to ~$22.6M | Deliberate increase in marketing and brand development investment, which drove revenue growth for the first time in nine quarters. |
| Adjusted EBITDA | down to 8.4% from 9.5% of revenue ($3.3M) | Higher marketing/brand investment and elevated customer acquisition cost. |
| Customer acquisition cost | up to ~$3,400 from $3,130 per case | Increased investment in the media mix and marketing to rebuild demand. |
| Cash flow from operations | up to ~$5M from ~$1M | Improved profitability and working capital versus 2025. |
| Leverage | below 2.5x, down over one turn | Nearly $30M of debt repaid over the last five quarters, including $11M in Q1. |
Earnings Call Themes & Trends
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| GLP-1 market opportunity | not previously quantified | GLP-1 user base seen growing from ~5M in 2023 to 25M by 2030 (~400%) in a $200B market; 63% of patients interested in treatment implies nearly 19M potential body-contouring patients. | — |
| New procedures (skin tightening / skin removal) | not previously quantified | Over 150 skin excision procedures in Q1; still in pilot/rollout, potential to unlock more than $100M in long-term revenue across existing centers. | — |
| Sales and marketing strategy | initiatives launched at the end of 2025 | Expanded media mix including Connected TV, influencer engagement, and targeted campaigns, plus improved digital funnel/website and sales execution, driving higher-quality leads, better conversion, and revenue. | — |
| Financial discipline / debt reduction | nearly $30M repaid over last five quarters (per prior call) | Leverage below 2.5x (down over one turn); term loan refinancing in process, details to be shared with Q2 results. | — |
| Same-store sales trajectory | negative comps for over two years | First positive same-center sales in over two years; +1% same-store ex-London; targeting sequential improvement in Q2. | — |
Q&A Summary
What is driving the Q1 improvement, and how much is due to enhanced marketing versus new skin-tightening services versus a better body-contouring demand environment?
Management attributed the improvement primarily to the enhanced marketing strategy and the foundational work done in 2025, which is showing up in leads, consults, and revenue. The new expanded procedures are still in pilot and not yet a meaningful contributor. The consumer environment remains challenging, especially for considered purchases, but the building blocks for growth are in place with more upside expected as the year progresses and new procedures scale.
With the balance sheet strengthened, will the company consider opening de novo centers again later this year, or is that a 2027 dynamic?
No de novos are contemplated in 2026. The short-term focus and number-one priority is improving same-center sales growth, of which Q1's positive comp was a big step. De novos remain a long-term opportunity to be pursued at the appropriate time, but nothing is planned for the year.
Are the newer skin removal and skin tightening procedures contributing meaningfully to revenue yet?
Not yet. Over 150 skin excision procedures were completed in Q1, but the procedures are still in pilot phase and being rolled out across centers, so they have not been a meaningful incremental contributor. Management remains excited about the early progress and learnings and expects the opportunity to expand through the year.
How is the consumer/demand environment trending?
The consumer environment is still challenging, particularly for considered purchases, but demand has stabilized and the company's own marketing and sales actions are driving the revenue improvement rather than a broad demand recovery.
What is the outlook for Q2?
Q2 is the seasonally strongest quarter, and the company is entering it with continuing positive momentum, targeting sequential improvement in same-store sales and expecting sequential improvement in both revenue and EBITDA in absolute dollars versus Q1.
What is the status of the debt and refinancing?
The company repaid $11 million of debt in the quarter and nearly $30 million over the last five quarters, bringing leverage below 2.5x. It is in compliance with all credit-agreement covenants and is in the process of refinancing its term loan, with details to be shared when Q2 results are reported.
More on Airsculpt Technologies, Inc.
Reported 2026-05-08 · figures from the Airsculpt Technologies, Inc. Q1 2026 earnings call.
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