Ann Custin - 08 Dec 2021 Form 4 Insider Report for ESTABLISHMENT LABS HOLDINGS INC. (ESTA)

Role: Director
Signature: /s/ Rajbir S. Denhoy, by power of attorney
Issuer symbol: ESTA
Transactions as of: 08 Dec 2021
Net transactions value: $0
Form type: 4
Filing time: 10 Dec 2021, 15:39:16 UTC
Previous filing: 15 Jul 2021
Next filing: 01 Feb 2022
SEC: View on sec.gov

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	ESTA	Stock Option (Right to buy)	Award	$0	+12,000		$0.000000	12,000	08 Dec 2021	Common Shares	12,000	$69.05	Direct	F1, F2

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	As disclosed on a Form 4 filed with the Securities and Exchange Commission on July 15, 2021, the Reporting Person was previously granted an option to purchase common shares of the Issuer. The Issuer subsequently determined that the foregoing grant did not comply with the terms of the equity incentive plan under which it was granted and is void and of no force and effect. On December 8, 2021, the Reporting Person was granted the new stock option reported herein.
F2	One-third of the shares subject to the option shall vest on July 13, 2022 and each one-year anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.

Content

As disclosed on a Form 4 filed with the Securities and Exchange Commission on July 15, 2021, the Reporting Person was previously granted an option to purchase common shares of the Issuer. The Issuer subsequently determined that the foregoing grant did not comply with the terms of the equity incentive plan under which it was granted and is void and of no force and effect. On December 8, 2021, the Reporting Person was granted the new stock option reported herein.

One-third of the shares subject to the option shall vest on July 13, 2022 and each one-year anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.