Tela Bio Aims for 8% Revenue Growth in 2026 as It Drives Commercial Transformation

Key Highlights from TELA Bio’s Q4 2025 Earnings Call

During the recent earnings call, TELA Bio, Inc. (TELA) provided a detailed overview of its performance in the fourth quarter of 2025 and outlined its strategic direction for 2026. The company emphasized significant changes across its operations, with a focus on strengthening its commercial foundation and driving long-term growth.

Management Perspective

Antony Koblish, Co-founder, CEO & Director, highlighted that 2025 was a transformative year, particularly in the third and fourth quarters. He noted that the company executed a major rebuild of its commercial structure, resulting in “16% full year growth and achieving record fourth quarter revenues.” Koblish also mentioned that the company is entering 2026 with the largest and most effective field team in its history, designed to support sustainable growth.

Koblish emphasized the hiring of high-caliber sales representatives, with “40% of the reps having joined TELA in the last 6 months.” This move was described as an investment in commercial expansion and talent recruitment, rather than turnover. He added that new hires are already outperforming their predecessors during the onboarding process.

Product innovation remains a key focus, with plans for additional product launches throughout 2026 to gain market share in the U.S. The company also announced the promotion of Dr. Howard Langstein to Chief Medical Officer, effective March 1.

European operations were reported as stable and delivering above-plan results, with strong adoption of OviTex in the U.K. and Netherlands. The company launched OviTex LTR, initiated the ECHO trial for hiatal hernia, and reinforced its debt facility.

Jeffrey Blizard, President, detailed the commercial reorganization, noting that the team now includes “88 quota-carrying territory managers in the U.S.” He stated that the team needed to meet 2026 targets is largely in place.

Roberto Cuca, CFO & COO, shared financial results, stating that “Revenue for the fourth quarter of 2025 increased 18% year-over-year to $20.9 million and grew 16% for the full year to $80.3 million.” OviTex unit sales rose by 20% for the quarter and 22% for the year, while PRS unit sales grew by 12% for both the quarter and the year.

Outlook and Guidance

Management projected “revenue growth of at least 8% over 2025” with Q1 2026 revenue expected to be approximately $18.5 million. Koblish explained that the guidance reflects the company’s need for flexibility given the organizational changes and the introduction of new sales representatives. He noted that there are many variables and that the company wants to ensure it has enough room to adapt.

Cuca described the expected revenue cadence for 2026, stating that it would follow a similar pattern to previous years, with a step-up from Q1 to Q2, a smaller increase from Q2 to Q3, and a larger step-up from Q3 to Q4.

Koblish reiterated the importance of contract execution, emphasizing the need to translate signed contracts into patient care and revenue.

Financial Results

In addition to the revenue growth, OviTex revenue grew by 12% and OviTex PRS revenue increased by 20% for the full year. LIQUIFIX revenue “more than tripled over the fourth quarter of 2024.”

European sales accounted for 15% of total revenue in 2025, reaching $12.1 million, a 17% increase over 2024. Gross margin was 66% for Q4 and 68% for the full year. Operating loss was $6.6 million in Q4 and $33.8 million for the year, with a net loss of $9 million in Q4 and $38.8 million for the year. The company ended 2025 with $50.8 million in cash and cash equivalents.

Q&A Session

Analysts raised questions about the reduction in growth guidance from 15% to 8% for 2026. Koblish explained that the change was due to the extensive organizational changes and the need for prudence. Jim Hagen, Senior VP, noted that 2026 is an execution year, with a focus on translating contracts into revenue.

Frank Takkinen asked about the drivers behind a potential double-digit quarter-over-quarter decline in Q1. Koblish cited smaller territories and the splitting of territories as reasons, adding that the company will concentrate more reps in smaller areas, which may cause some short-term losses.

Michael Sarcone questioned the reduction in 2026 guidance from 15% to 8%. Hagen responded that the assumptions had changed, reflecting a longer and more complex change curve.

Matthew O’Brien pressed on the low Q1 revenue guide and the required back-end loaded performance. Hagen acknowledged that January volumes were low and that weather-related disruptions affected elective procedures.

Sentiment Analysis

Analysts expressed skepticism about the significant drop in growth guidance and the impact of organizational changes. They raised concerns about the prudence of the outlook and the ability to execute effectively.

Management’s tone remained cautious, emphasizing the need for flexibility and the unpredictability of recent changes. Compared to the previous quarter, the tone shifted from optimism about expansion to a more guarded stance, reflecting uncertainty around the impact of sales force changes and territory realignment.

Quarter-over-Quarter Comparison

The previous quarter’s call outlined a directional expectation of at least 15% revenue growth for 2026, compared to the current 8% guidance. Strategic focus shifted from aggressive expansion to consolidation and execution. Analysts’ questions moved from financing and commercial structure to concerns about guidance downgrades and operational risks.

Risks and Concerns

Challenges include the onboarding and productivity ramp of new sales reps, territory realignment, and contract execution complexity. Management noted that contract implementation varies between hospitals and that contracting complexity affects timing. Weather-related disruptions and lower procedure volumes in January were acknowledged as impacting Q1 performance.

Analysts voiced concerns about the ability to achieve back-end loaded growth targets and the timeline for achieving steady-state productivity.

Final Takeaway

TELA Bio management emphasized that 2025 marked a foundational transformation, with the commercial team rebuilt, new leadership established, and a significant investment in sales force expansion. Growth guidance for 2026 is set at a cautious 8% as the company focuses on executing its new commercial model, achieving deeper account penetration, and integrating a wave of new territory managers. Management expressed confidence that the groundwork laid during this organizational shift positions TELA Bio for sustainable long-term growth, even as near-term projections are tempered to account for the transition’s inherent variability and complexity.