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 will also be available on our website. Michael will then review our fourth quarter and fiscal 2025 financial performance and provide the 2026 outlook. In the fourth quarter, we delivered sequential improvement in same-store sales versus the first nine months of the year and higher adjusted EBITDA compared to Q4 2024.

We also saw improvements in our lead and consult volumes, which has continued into 2026 and is now converting into improved revenue trends. Our trends continued favorably in March, and we expect Q1 same-store sales to be flat, which would be the midpoint of the revenue range previously provided. As we prepare for our busiest quarter, we are seeing broad-based improvement in revenue across our centers. They have also created demand for aesthetic procedures such as skin tightening, contour restoration, and overall reshaping after weight loss, all of which play into our existing brand and capabilities.

Skin removal procedures represent another proof point of our expanded revenue opportunity. We have also deployed marketing efforts to raise awareness of our unique positioning to serve these patients. These new procedures strengthen our body contouring service and revenue streams using our existing base of centers and clinic talent. Turning to our third area of focus, maintaining strong financial discipline both in our margins and capital allocation.

What went well
  • Q4 adjusted EBITDA rose to $2.5 million (7.4% of revenue), up $0.6 million with 2.8 points of margin expansion versus Q4 2024, driven by gross margin gains and SG&A leverage.
  • Q4 gross margin expanded roughly 2 points to approximately 59%, as cost of services fell $3.1 million to $13.7 million (down 18% year over year).
  • Same-store sales inflected from down 22% at the start of 2025 to positive in February 2026, with favorable trends continuing in March and Q1 comps expected to be flat.
  • Cost discipline generated over $4 million in annualized savings in 2025, and Q4 SG&A declined about $5 million versus the prior-year quarter to roughly $18.2 million.
  • Balance sheet strengthened: over $30 million of debt repaid across the last five quarters bringing leverage below 2.5x currently, plus $14.8 million raised via the ATM in Q1 2026 and an additional $11 million of debt principal paid down.
  • Completed more than 100 skin removal (excisional) surgeries in the Q4 pilot, adding to standalone skin tightening as new procedures targeting a stated $100 million+ long-term GLP-1-driven opportunity.
What went wrong
  • Q4 revenue fell approximately 15% year over year to $33.4 million, with same-store revenue down 16%, reflecting lower case volume amid a challenging consumer spending environment.
  • Full-year 2025 revenue declined about 15.8% to $151.8 million, and adjusted EBITDA dropped to roughly $15 million (10% margin) from about $21 million (12% margin) in 2024.
  • Cash flow from operations fell to $3.1 million for the year from $11.4 million in 2024, and year-end cash stood at just $8.4 million.
  • The 10-K filing was delayed after an intercompany reconciliation matter prompted a broader accounting review (including ASC 842 leases), resulting in immaterial prior-year corrections and an acknowledgment that controls need strengthening.
  • A meaningful portion of global helium plasma supply, which is needed for skin tightening procedures, is currently offline due to the Iran conflict, creating a supply risk the company is monitoring.

Guidance Changes

MetricPeriodCurrent guidance
Full-year revenueFY2026$151 million to $157 million; midpoint implies roughly 3% comparable growth excluding London
Full-year adjusted EBITDAFY2026$15 million to $17 million
Same-store salesQ1 2026expected flat, the midpoint of the prior range
De novo center openingsFY2026no new openings contemplated; resources focused on revenue growth in existing base
Net debt leverageOngoingtargeting below 2.5x with a planned term loan refinancing before it becomes current

Performance Breakdown

MetricYoYNote
Q4 revenue down approximately 15% to $33.4 million Lower case volume amid a challenging consumer spending environment.
Q4 same-store revenue down 16% Reduced case volume; excludes centers open less than a year.
Q4 gross margin up roughly 2 points to about 59% Cost of services down 18% ($3.1 million) to $13.7 million.
Q4 SG&A down about $5 million to roughly $18.2 million 2025 cost initiatives.
Q4 adjusted EBITDA up $0.6 million to $2.5 million (7.4% margin, +2.8 points) Gross margin expansion and SG&A operational leverage.
Full-year revenue down approximately 15.8% to $151.8 million Weak case volume through most of 2025 before stabilization.
Full-year adjusted EBITDA down to about $15 million (10% margin) from about $21 million (12% margin) Lower revenue, partly offset by cost reductions.
Cash flow from operations down to $3.1 million from $11.4 million Lower profitability during the rebuilding year.

Earnings Call Themes & Trends

TopicPrevious mentionCurrent periodTrend
Same-store sales trajectorydown 22% at the start of 2025positive in February 2026, favorable in March, Q1 expected flat
GLP-1 / new proceduresstandalone skin tightening rolled out to all centers in H2 2024; skin excision pilot launched in Q4 2025100+ skin removal surgeries done in Q4, expanding to all locations in 2026; stated $100 million+ long-term opportunity
Sales and marketing strategyprior approach ahead of the Q4 2025 revampenhanced strategy launched Q4 2025 (connected TV, influencers, skin campaigns, website conversion, higher-value targeting) driving improved volume trends
Capital allocation / leveragedebt reduction the stated focus; over $30 million repaid across five quartersleverage below 2.5x; planning term loan refinance, then reinvestment in sales/marketing and eventually de novos
Geographic footprintoperated one center outside North America (London), contributing 1% to 2025 compsstrategically exited the only non-North American clinic to streamline operations
Leadership / talentteam being rebuilt through 2025new CFO (Michael Arthur) plus added senior finance, legal, and operations executives in Q1

Q&A Summary

Why is 2026 revenue more back-end loaded, with Q1 guidance implying a slight year-over-year decline while the full year is up slightly?
Yogi said the company is being measured in its guidance; trends have improved meaningfully from down about 22% to positive comps exiting the year, which underpins confidence in the full-year outlook, but the team is focused on delivering consistent execution to hit its numbers.
Can you isolate the core body-sculpting market trends outside of the new GLP-1-related procedures?
Yogi said the core body contouring and fat removal business is holding relatively steady; aesthetics saw a post-COVID boom and is now finding a baseline, and GLP-1-driven skin laxity demand is seen as the next wave that plays well into AirSculpt's brand and capabilities.
On the roughly 100 excisional procedures in the Q4 pilot, what are you hearing from patients and surgeons, and how does that inform the broader rollout?
Yogi said patients are getting excellent results (final results take about three months), surgeons are comfortable and effective with the procedures, and the company is pleased with both volume and quality; it will review outcomes, make any needed corrections, and ramp the rollout through the year.
With leverage down to 2.5x after debt paydown, how should we think about capital allocation and appetite for further debt reduction?
Michael said getting the balance sheet healthy remains the top priority; the company is in early stages of refinancing its debt targeting around current levels and below net debt of 2.5x, after which the unchanged strategy is to reinvest in the business across sales and marketing and, eventually (not in 2025), new de novo clinics.

More on Airsculpt Technologies, Inc.

Reported 2026-04-02 · figures from the Airsculpt Technologies, Inc. Q4 2025 earnings call.

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