Thank you everyone for joining us. I'm Yogi Jashnani. I serve as the CEO for AirSculpt and will walk you through who we are and what's going on in the business. It's a really exciting business. Before we jump in, of course, the disclaimer and forward-looking statements. We are publicly listed on the Nasdaq. Who are we? We are a premier body contouring service provider. We do procedures such as fat removal, fat transfer, skin tightening across 31 corporate centers. We do about $150 million in top line also, and about 10% EBITDA margin, 60% gross margin. That's a little bit by the numbers.
Getting into the meat of it, our procedures and what differentiates us is we have a patented process for doing the fat removal, fat transfer and skin tightening. These are minimally invasive procedures, so you're going in without any scalpels, stitches or general anesthesia. We go in through a 2 mm or smaller opening with a cannula and literally sucking the fat out from people's body. It's done under local. People are awake. Our patients are awake through the procedure, and many people are back to their normal routines within 24-48 hours, right? It is an elective procedure, so it's 100% cash payment. There is no insurance involved, and we get paid upfront.
That's a little bit of, you know, the process itself. You know, our core customer, she is 35 to 55 typically, and she's looking to invest in herself. Higher household income, over a $100,000 median household income. Our locations are all 31 locations of us are in, you know, metropolitan areas, high-end retail. It'd be next to The Plaza in New York City. We'd be just off Rodeo Drive here in Los Angeles. Our model works in big cities, Tier 1, Tier 2 and Tier 3 cities. All of our locations are cash flow positive. Our average procedure is about $12,000-$13,000, as I mentioned.
Couple of things for 2026, we've provided a guidance of roughly a midpoint which reflects 2.5% same-store sales growth and a adjusted EBITDA guidance, which re-reflects about 28% growth on adjusted EBITDA at the midpoint. What's that based on, right? I joined the business early 2025, and we were doing negative same-store sales growth as we are coming off of a baseline distortion coming from COVID and a couple of other internal things that we had to take care of. Over the last 12 months, we have turned around same-store sales from - 24 to we just announced our first positive quarter in Q1 in over two years. We've been seeing improving revenue trends and that translates into EBITDA growth as well. Three key drivers of growth.
What's driving that growth? Here and now, today, it's enhanced marketing strategy. The next growth vector that's coming in is around service expansion and future growth vectors around footprint expansion. Let me explain each of those. When you look at going from same-store sales of negative 20-odd to positive, we are fundamentally from a consumer perspective, a D2C business on the front end. We engage our customers using, you know, your paid media marketing, whether it's paid social, paid search, influencers, word of mouth. We engage our consumers that way. We do a consultative sales with them to build a custom treatment package. Remember, these are surgeries, so you're working with a sales consultant and your surgeon to get the surgery designed for you. Then, we execute on that within our four walls, within our corporate centers.
Over the last year or so, we've been able to drive revenue growth by optimizing where we are spending our marketing dollars. Which channels are we going into? Who are we targeting? Sharpening our targeting focus and really expanding into some of the channels where she lives and where she's consuming media. That's driven a 20-point-plus growth in same-store sales from where we were to + 1. That's growth that's happening right now. The next set of growth is in GLP-1s. Don't worry, I'm not looking to sell GLP-1 pills. What we are seeing is there is a lot of side effects of GLP-1s which we can address. Let me explain. GLP-1 usage stats on the left. This is from McKinsey studies. Many of you all would have seen it.
From 5 million users in 2023 to estimated, you know, 25 million users, soon enough. 60%-70% of GLP-1 users, what they tend to see is a couple of major side effects. One is loose skin. People who've been on GLP-1s, they see loose skin or skin laxity as a major side effect. The other is, "Hey look, I took GLP-1s. It reduced fat, but I still have stubborn fat deposits." GLP-1s works generally. It's not precision contouring. We have solutions. Our fat removal is precise. It's targeted. We've seen interest from GLP-1 users to complete their aesthetic journey and do the fat removal.
We also are seeing increasing demand from patients who have a lot of loose skin and are looking for solutions for that. What we have done is middle of last year, we expanded to skin tightening. Remember, we've been doing fat removal, fat transfers. We've also been doing skin tightening, but in conjunction with those procedures, we started expanding to standalone skin tightening. That's gone off well. Our skin tightening penetration is really high right now. Q4, we also started to do skin removal. If you've gone on GLP-1, you've lost some weight, you can tighten the loose skin. You've lost a lot of weight, you need some skin removal as well. We are seeing that demand in the marketplace. We are seeing patients who are coming in with so much loose skin that we have to do skin removals.
We are staying true to our body contouring roots. We are staying true to our, you know, procedures which can still be done in our offices. These are outpatient procedures done under local anesthesia while you're awake, so slight nips and tucks to remove some skin and remove that loose skin to improve your body contouring and deliver a smoother, a better, and a more defined result. That pilot's going well. We did about 100 such skin removal surgeries in Q4. We're doing about 150 in Q1, and that continues to grow, and there's a lot of consumer interest. What's getting us to positive comps is the current base of the business and running that better.
The next set of growth is in pilot already through skin removal, skin tightening, and addressing the side effects of GLP-1. Remember, everybody's looking to sell GLP-1s. We believe we are the scaled player who can address the side effects of GLP-1, right? Nobody's really looking at that space as far as we can tell. From a future growth perspective, we have 31 centers today, roughly one in each major metropolitan area. When we do the work, we see there's another 100 that we could add in the U.S. from a growth perspective. We used to open five new locations every year, we have a track record of opening de novos. Many, most of them have paid back within a year. Okay? That's somewhat unheard of in consumer businesses at times. We see this as a growth level.
It's a proven growth level for us, and as we stabilize revenue and as we continue to grow same-store sales, this is something which is a future growth level for us that we're really excited about. Just to give you guys some, you know, sense, I live in Tampa, Florida. We don't have an AirSculpt over there. We are not in Indianapolis. We're not in Long Island. We're not in Portland. There are big, major centers of population where we are not there. There's a lot of white space for us to go. This map is what you see on slide 13. This is where we can go.
You see a lot more dots, there's at least another 100 that we believe we can plop without significant cannibalization over the next few years. Right? From a growth perspective, multiple growth levels. We are back to growth as of Q1 this year. We're seeing the current base business is growing. We have growth coming through new procedures and expansion of procedures, and there's future growth opportunities by just expanding our geographical footprint just here in the U.S. itself. It's an exciting time to be in the business. To walk you through what's been going on on the balance sheet side, I'll invite Michael Arthur, our CFO.
Yeah. Thank you. Thank you, Yogi. Good to see everyone. Yeah. We wanna walk you through what we've done on the balance sheet as well as what we're doing in the background on the operations side of the house. As you can see on this chart, you know, we've significantly shored up our balance sheet and strengthened our financial position over the last 12 months. You know, we've decreased debt from roughly $75 million at the start of last year to down to $46 million at the end of Q1 that we just reported. We've also increased cash during that period as well. We ended Q1 of 2026 with roughly $16.7 million in cash on the balance sheet.
We've really shored up the balance sheet on both ends of the spectrum, and that's also resulted in a better leverage ratio. We're now below 2.5x on a net debt to EBITDA basis. It's just given us better financial flexibility and an ability to kinda reinvest in the business as we go forward. Obviously, our leverage ratio, we expect to continue to come down as we grow EBITDA. Lastly here, we're keenly focused and progressing well on refinancing our current debt. Our debt comes current in Q2 of 2026, we're looking forward to refinancing that shortly, and we'll be providing an update in our Q2 earnings call here in August.
As we've been shoring up the balance sheet, we've also been shoring up operations. We in the last year have effectively refreshed the executive team. Yogi started in January of 2025. I started in January of 2026. We've also since then have hired a president of operations in the last couple months, as well as a general counsel. That's allowing us to kind of ensure tighter alignment across the finance group, operations, clinical, and our sales and marketing team, and we're already starting to see that in how we just run the business day to day. We're just more nimble. We're executing on key priorities. We're moving faster across kind of the value chain. It's still early days, but we're really excited about what we're doing there. We've also streamlined operations.
We've identified and executed on roughly $4 million of annualized savings, really just through reducing complexity, increasing efficiencies, and we still have a lot more opportunity there to just improve overall efficiencies in how we run the business. As I alluded to, with a new team, we're turning over every rock, finding ways where we can work together more effectively and efficiently, and that's gonna generate further cost savings I'm confident of. Then third, I think it's just a commitment to operational excellence and having that mentality that we build a culture of accountability, continuous improvement, looking at everything we do through kind of this new lens with exec team and finding ways to do it better and more efficiently and drive both top line and bottom line profitability.
I'll kinda leave you with this as the key takeaways here, which is, really we're executing on our key priorities. The first is we've returned to growth, so as Yogi alluded to, Q1 comp growth is the first time we've seen that in two years, + 1%, largely driven through our enhanced sales and marketing strategy and optimization of those groups. We're seeing that bear fruit in Q1, which we're really excited about. In addition to that, we've been introducing new services, expanding revenue streams there to involve kinda capturing that GLP-1 opportunity that we think is really huge, and it's somewhat of an unmet market right now of the side effects of GLP-1 patients. Then, you know, we're streamlining the business.
We're strengthening the balance sheet, making ourselves more flexible and nimble to grow really efficiently and capture that opportunity when we see it. That's given us a lot of confidence that we're working on the right things and we're moving the business forward in a positive direction. That's also allowed us, as Yogi alluded to kinda reaffirm our guidance at the midpoint of $154 million annualized for 2026, which implies a 2.5% roughly comp growth. That's, you know, implying continued improvement comp quarter-over-quarter relative to Q1. EBITDA $15 million-$17 million, which is, you know, 20% growth EBITDA from 2025 as well. We're really excited about what we have here. We're working on the right things. We're executing. We think we have a lot of opportunity as a company going forward, which we're excited about. I'll leave you there. Yes, question?
What are you going to do to refinance the debt?
We're currently in process there. We're working with our current lender, lending group, and we've engaged with a financing partner as well to run a process.
Are you going to issue more stock? Are you going to issue bonds here?
We're just looking to roll it over. Yeah, we feel like the debt's in a good place now. Our focus is really just refinancing what we have on the balance sheet. Yep.
You see a location. How long does it build out? Do you lease it? Do you buy it? I mean, I would assume you take the location all, or you take a section of it. Do you lease a section of the Like an urgent care that might have a phys. You know what I'm saying?
Yeah.
Try and use that? I'm not gonna build out a whole new place. I'm gonna just take out, I guess, a place in one there and let me just revamp it.
Yeah. We lease all of our clinics. They're usually in medical centers.
Right.
You know, there's some outfitting. usually our outfit cost to kind of get it up and running is around-
How much build out? It's just, you know, go in there.
Equipment
Section-
Yeah.
Build out that section.
Yeah.
Okay.
Correct. It's roughly $1 million to kind of build out a clinic. Yeah.
I have houses in Boca, and they're everywhere.
Yeah.
You know? I see them go in and out of business there, and I was like, you know what? As you talk, I'm thinking you could walk in there and say, "Okay. Put my machines in there, maybe, you know, refit it, and I can be up and running in two months with.
Yeah. Yeah.
Patients, you know, whatever it is, 30, 60 days to be up and running.
Yeah.
You know, 'cause they're everywhere in South Florida.
Yeah.
You know?
Yeah. We're bullish on our ability to add clinics. The economics are really attractive. You know, they pay back mostly within 1 year, which is kinda unheard of for any sort of retail multi-site location.
My daughter's seeing a physiologist, and she goes, "There's just not enough places.
Yeah. Yeah.
They're so backed up that, you know, it'd be nice if they opened up some more of these centers. Like, you know, it's just funny you saying that you could walk into an area.
Thank you.
Yeah.
Thank you for the affirmation.
Yeah.
There, there normally would be two to three weeks' book time. Now it's two to three months' book time.
Yeah.
Just to get in. The GLP explosion has caused them a ton of business, and they all come in with disproportionate fat distribution, which is fats hanging where you're not supposed to.
That's exactly what we're seeing.
The impact of each surgery, we track any complications that might arise, and we look for, you know, are there any trends within that? Is there anything that needs to be corrected? You know, with any surgery there's some risks, but we track that really closely to make sure that we are managing the quality of both the surgical outcomes but also the patient satisfaction. Thus far, we've been pleased with what we do. We are constantly improving procedures. The last thing which I would say is, we're not trying to be all things to everyone. Like, by focusing on the procedures that we are doing, we've become really good at those. As a result of that repetition, allows us to maintain and improve quality on an ongoing basis.
What is Just out of curiosity, what is your % of complications?
The, we don't publish that, but it's below industry standard. Industry standards tends to be low single digits, and we tend to come in below that. Yeah?
Is there other procedure besides the plastic surgery for skin tightening? Do you have another type of science that does that, or is that the only thing you do?
For skin tightening, the question was, how do we address loose skin, I think if I'm paraphrasing your question.
You have other kind of science that might involve that?
Yeah. There's two approaches we do. One, the skin excision is actually new. That's in pilot phase right now. Historically, we've also done skin tightening using, you know, helium plasma technology. There, we use a device from Apyx Medical called Renuvion. That's what we use in our locations. That's used for skin tightening, either as part of fat removal surgery or standalone by itself as well. That's one technology we use, and then we do skin excisions. Those are the two primary ones we use. Yes.
What are the operational costs? It's just labor and machine or anything else?
Yeah. The question was, what's the cost of the procedure, our costs? Our gross margin is roughly 60%, so 40% is the cost of service. 20% or half of that's roughly paying our physicians. Our physicians are 1099 contractors, and it's basically a revenue share agreement. They get 20% of every case that they perform. There's about 15% that's between nursing and medical supplies. Our nurses are also, they're hourly, and medical supplies obviously vary with each procedure. Very low overhead to deliver the service. It's all variable. Our least cost is roughly 5%. Yes.
Are you doing all of your procedures at your own facility, or do you leverage some third-party surgery centers?
Yeah, the question is, do we do all of our procedures at our current facilities? The answer is yeah. We run and operate only in our own facilities.
After the first treatment, how long do the customers usually have to return and how long does that treatment take?
I can take it.
Yeah.
The question was around repeat customer visits. Ours is permanent fat removal, people come in for the surgery. They get the surgery done. They're coming back for checkups, we typically follow up with the person same day. There's a visit at one week, and depending upon the procedure, there'd be typically visits at three months and six months. From a procedure perspective, once you've gotten the procedure, that's permanent fat removal, where you're awake, you can literally see the fat coming out in the canister. The repeat customers would generally tend to be if people want to get other body areas done. Thankfully, our procedure is effective enough that there isn't a need to address the same body area again, at least not right away.
Is any part of procedure covered by CPT codes? Anything covered?
We do not work in the insurance space at all, so it's all cash, it's all cash pay for us.
Do you do any cold, CoolSculpting or is it all just surgical?
It is all surgical. We do not do CoolSculpting. Any last questions? All right. Thank you.