TELA Bio (NASDAQ:TELA) reported fourth-quarter and full-year 2025 results that management characterized as a period of “meaningful strategic change,” marked by a major rebuild of its U.S. commercial organization while still delivering double-digit revenue growth and record quarterly sales.
2025 results and growth drivers
For the fourth quarter of 2025, the company reported revenue of $20.9 million, an 18% increase year over year. Full-year 2025 revenue rose 16% to $80.3 million, surpassing $80 million in annual sales, according to management.
Cuca added that OviTex revenue grew 12% for the year and OviTex PRS revenue grew 20%. Unit volumes also expanded, with OviTex unit sales up 20% in the fourth quarter and 22% for the year, while PRS unit sales increased 12% in both the quarter and the year. LIQUIFIX revenue “more than tripled” compared with the fourth quarter of 2024, which management attributed to early traction as adoption expands alongside OviTex.
Internationally, European sales represented 15% of total 2025 revenue, or $12.1 million, up 17% from $10.3 million in 2024. Koblish said the European team is “stable, tenured and delivering above plan,” and highlighted rapid adoption in the U.K. and the Netherlands, emphasizing that share gains were driven by patient preference and product efficacy rather than pricing discounts or volume commitments.
Commercial restructuring and sales force expansion
Management repeatedly returned to commercial execution as the central theme of the call. Koblish said the company executed “a significant rebuild” of its commercial foundation following Jeffrey Blizard’s appointment as president in June 2025, including investments in training, new sales enablement tools, a new U.S. sales leadership structure, and a redesigned 2026 compensation plan.
Blizard outlined a series of changes aimed at increasing accountability and improving field execution, including a sales general manager structure, upgrades to five senior commercial leadership roles, formal promotion pathways, and a shift in recruiting toward candidates selected for attributes such as intellect and perseverance rather than primarily years of soft tissue sales experience.
He also provided updated headcount figures for the U.S. field organization. The company reached its target of 76 territory managers in the third quarter, and as of the call had 88 quota-carrying territory managers in the U.S., with one additional hire expected and five open roles being sourced. Blizard said the team required to meet 2026 targets is “largely in place,” and the company does not expect further incremental hiring for the remainder of the year.
Management said a significant portion of the sales force remains early in its tenure. Koblish said approximately 40% of representatives joined in the prior six months, describing the change as expansion rather than turnover. Blizard added that new hires are expected to reach full productivity in roughly 6 to 9 months, and he described three cohorts: newly hired reps ramping up, a 6-to-18-month cohort reaching a “productivity inflection point,” and a tenured cohort that averages over $1 million per year and represents about 35% of the current rep count.
Strategic focus: deeper account penetration, contracting execution, and portfolio expansion
In discussing 2026 priorities, management emphasized both commercial execution and product innovation. Koblish said TELA expects to announce additional product launches during the year and pointed to the launch of OviTex LTR in the second half of 2025, described as a tissue-based alternative to synthetic mesh that provides durable support during healing.
Blizard said the company’s 2026 compensation plan is designed to incentivize deeper penetration in target accounts and a shift away from a “wide and shallow approach.” Instead, TELA plans to match rep density with high-volume institutions to cultivate multiple users per site, reduce geographic coverage burdens, and improve efficiency.
On contracting, management acknowledged complexity and said the company is shifting emphasis from signing agreements to executing within the existing footprint. Senior Vice President of Strategic Operations and Marketing Jim Hagen said the team made progress signing agreements in 2025, but called 2026 “an execution year” focused on translating signatures through hospital processes into patient usage and revenue. Koblish added that even with GPO contracts in place, implementation can vary by hospital and may be affected by market-share requirements, bundling, and rebate structures.
Guidance: “prudent” outlook amid transition
For 2026, the company guided to revenue growth of at least 8% over 2025 and said it expects approximately $18.5 million in revenue for the first quarter of 2026. Executives described the guidance approach as intentionally conservative given the breadth of organizational change and the large number of new hires still ramping.
In response to questions about a step-down in outlook versus prior commentary, management said the scale and complexity of change proved larger than initially assumed, prompting a more cautious posture. They also described typical seasonality—step-up from Q1 to Q2, smaller increase from Q2 to Q3 due to summer holidays, and a larger step-up from Q3 to Q4—and said that pattern could be “slightly amplified” as recently hired reps reach break-even and then “break out” later in the year.
Executives also cited external and transitional factors affecting the first quarter, including lower January procedure volumes coming out of the holidays, elective procedure disruption from storms in densely populated regions, and the effects of restructuring territories into smaller geographies to support deeper account focus.
Margins, expenses, cash, and pipeline highlights
Gross margin was 66% in the fourth quarter and 68% for the full year, up from 64% and 67% in the prior-year periods. Cuca attributed the improvement to lower excess and obsolete inventory expense as a percentage of revenue.
Operating expenses reflected a mix of increased commissions and cost controls. Sales and marketing expense was $14.5 million in the fourth quarter and $63.2 million for the year, compared with $14.0 million and $64.6 million in the prior-year periods, with higher commissions offset by lower compensation, severance, consulting, and travel costs for the year. General and administrative expense rose to $3.8 million in the quarter and $15.7 million for the year, while R&D expense was $2.1 million in the quarter and $9.2 million for the year.
Loss from operations was $6.6 million in Q4 and $33.8 million for the year. Net loss was $9.0 million in Q4 and $38.8 million for the year. Cuca said the company expects operating loss and net loss to continue declining over the year and sequentially by quarter, though he anticipated a step-up in losses from Q4 to Q1 due to typical revenue progression.
TELA ended 2025 with $50.8 million in cash and cash equivalents and said it strengthened financial flexibility by refinancing its debt facility and raising incremental equity capital. Koblish also highlighted the enrollment of the first patients in the company’s ECHO hiatal hernia trial, which management said is intended to strengthen the clinical evidence base, and announced the promotion of Dr. Howard Langstein to Chief Medical Officer effective March 1, with responsibilities including surgeon awareness and clinical education around data supporting OviTex.
About TELA Bio (NASDAQ:TELA)
TELA Bio, Inc (NASDAQ: TELA) is a commercial‐stage medical technology company headquartered in Malvern, Pennsylvania. The company is focused on developing, manufacturing and commercializing regenerative medicine and advanced soft tissue repair solutions. By integrating proprietary biomaterials and processing technologies, TELA Bio aims to offer products that support the body’s natural healing processes in wound closure, hernia repair, reconstructive surgery and other surgical specialties.
The company’s product portfolio includes acellular dermal matrices, hemostatic agents and tissue scaffold systems.
