04 Sep BOAS Surgery in Dogs: Signs, Treatment Options, Risks and Cost
Flat-faced dogs such as French Bulldogs, Pugs and English Bulldogs are loved for their distinctive appearance and affectionate personalities. However, the same features that make these breeds so appealing can also create serious breathing challenges.
Many brachycephalic dogs develop Brachycephalic Obstructive Airway Syndrome (BOAS), a condition that restricts airflow through the upper airway and can affect a dog’s ability to breathe, exercise and regulate body temperature.
This guide explains what BOAS is, how to recognise the symptoms, available treatment options and what owners should know about BOAS surgery and its cost.
If you are concerned about your dog’s breathing, the team at Southern Cross Vet can help assess their airway and discuss appropriate treatment options.
For more detailed information about BOAS surgery.
Veterinary review and medical disclaimer
This article has been written and reviewed by a qualified veterinarian and is intended for educational purposes only. It does not replace personalised veterinary advice.
Every dog with suspected BOAS should be assessed individually by a veterinarian before treatment decisions are made. If your dog shows signs of breathing difficulty or exercise intolerance, professional veterinary advice should be sought promptly.
What is Brachycephalic Obstructive Airway Syndrome (BOAS)?
Brachycephalic Obstructive Airway Syndrome (BOAS) is a respiratory condition affecting dogs with shortened skulls and flattened faces.
These breeds have been selectively bred for their distinctive appearance. Unfortunately, this conformation can compress the airway and restrict airflow.
Breeds commonly affected include:
- French Bulldogs
- Pugs
- English Bulldogs
- Boston Terriers
- Cavalier crosses such as Cavoodles
Read more about common health issues affecting French Bulldogs and Pug specific information.
BOAS occurs due to a combination of anatomical abnormalities that obstruct airflow.
These may include:
- Stenotic nares
Narrow nostrils that restrict airflow through the nose.
- Elongated soft palate
Excess tissue at the back of the throat that partially blocks the airway.
- Everted laryngeal saccules
Small tissue structures that are pulled into the airway due to chronic pressure changes.
- Hypoplastic trachea
An abnormally narrow windpipe that restricts airflow to the lungs.
Multiple abnormalities are often present at the same time, increasing the severity of breathing difficulty (Oechtering et al., 2016).
Signs that your dog may have BOAS
Many owners assume that snoring or noisy breathing is normal for brachycephalic breeds. However, these sounds can indicate airway obstruction.
Common symptoms include:
- loud breathing or snoring
- snorting or reverse sneezing
- exercise intolerance
- rapid fatigue during walks
- difficulty cooling down after activity
- excessive panting
- gagging or choking when eating
- regurgitation or vomiting
- cyanosis, which is a bluish colour of the gums indicating low oxygen levels
- collapse in severe cases
Some dogs also prefer to sleep with their head elevated because it makes breathing easier.
If you notice these signs, it is important to consult a veterinarian for assessment.
Why BOAS can become dangerous
Dogs regulate body temperature primarily through panting.
Because brachycephalic dogs struggle to move air efficiently through their airway, they often have difficulty cooling themselves in warm weather.
This increases the risk of heat stress and heat stroke, which can lead to organ failure and even death if not treated promptly (Packer et al., 2015).
Excess body weight can further worsen BOAS symptoms by increasing oxygen demand and airway resistance.
Treatment options for BOAS
Treatment depends on the severity of the airway obstruction.
Non-surgical management
Dogs with mild BOAS may benefit from supportive management strategies such as:
- maintaining a healthy body weight
- avoiding exercise during hot weather
- limiting strenuous activity
- using slow feeders to reduce regurgitation
- monitoring breathing patterns carefully
While these strategies may help manage symptoms, they do not correct the underlying airway abnormalities.
Surgical treatment
For dogs with moderate to severe BOAS, surgical correction of the airway is often recommended.
Surgery aims to remove or reshape the structures that obstruct airflow, allowing the dog to breathe more easily.
BOAS surgical techniques explained
BOAS surgery typically involves correcting one or more anatomical abnormalities.
Common procedures may include:
- widening narrowed nostrils
- shortening an elongated soft palate
- removing obstructive laryngeal saccules
- addressing enlarged tonsils
- correcting turbinate obstruction within the nasal cavity
Some surgeons advocate the “5/5 BOAS surgery” philosophy, which involves correcting five anatomical structures in every case.
At Southern Cross Vet, we take a different approach. Each patient’s airway is assessed individually, and only the structures causing obstruction are corrected. This helps reduce unnecessary surgical trauma and anaesthetic time.
Minimally invasive BOAS surgery at Southern Cross Vet
Southern Cross Veterinary Clinic has developed a minimally invasive approach to BOAS surgery under the leadership of Dr Sam Kovac.
The procedure uses a specialised radiofrequency surgical handpiece to reshape the soft palate tissue while sealing blood vessels at the same time.
Compared with traditional surgical methods, this technique:
- reduces bleeding
- minimises tissue trauma
- shortens surgical time
- reduces the time spent under general anaesthesia
Many patients are able to return home on the same day once they have fully recovered from anaesthesia.
Anaesthetic safety for brachycephalic breeds
Brachycephalic dogs have a higher anaesthetic risk due to their airway anatomy.
For this reason, Southern Cross Vet requires the involvement of a dedicated veterinary anaesthetist for BOAS procedures.
A veterinary anaesthetist is a veterinarian who specialises in anaesthesia and pain management. Their role is to monitor the patient’s airway, breathing and vital signs throughout the procedure.
This approach helps maximise safety during surgery.
BOAS surgery cost in Australia: why a tailored approach matters
One of the most common questions owners ask when researching BOAS surgery is the cost.
Some clinics advertise fixed price BOAS surgery packages. While this may appear straightforward, it is important to understand that BOAS does not present the same way in every dog.
Each brachycephalic dog has a slightly different airway anatomy. Some dogs may only require nostril widening, while others may have multiple areas of airway obstruction that need to be addressed during surgery.
At Southern Cross Vet, we believe the safest and most effective approach is to tailor the surgery to the individual patient rather than applying a single standardised procedure.
Every surgery is tailored to your pet’s unique airway anatomy to optimise breathing and improve overall comfort.
This personalised approach allows our surgical team to carefully evaluate the airway and correct only the structures that are truly contributing to the breathing problem.
Typical BOAS surgery cost at Southern Cross Vet
BOAS surgery at Southern Cross Vet typically starts from $4000, but the final cost can vary depending on your dog’s airway anatomy and the surgical corrections required.
Factors that may influence the final cost include:
- the anatomical structures requiring correction (some clients just ask us about the dog’s soft palate surgery cost)
- the complexity of the surgery
- anaesthetic time
- additional diagnostic imaging if required
- involvement of a dedicated veterinary anaesthetist
An additional fee applies for the veterinary anaesthetist, which we strongly recommend for safety.
During your consultation, we will perform a detailed airway assessment and provide a clear, transparent estimate if surgery is recommended.
Why we prioritise safety over fixed pricing
BOAS surgery is not simply about correcting anatomy. It is about improving breathing while keeping your dog as safe as possible during the procedure.
At Southern Cross Vet, several factors contribute to both safety and outcomes.
These include:
- minimally invasive surgical techniques
- reduced surgical time under anaesthesia
- involvement of a specialist veterinary anaesthetist
- personalised surgical planning
While fixed-price packages may sound appealing, our priority is ensuring your dog receives the most appropriate treatment for their specific condition.
Risks and complications of BOAS surgery
All surgery carries some degree of risk.
Potential complications associated with BOAS surgery include:
- anaesthetic complications
- airway swelling after surgery
- infection
- bleeding
- aspiration pneumonia
- nasal suture failure
- need for temporary tracheostomy in rare cases
Published studies report complication rates ranging between 2 percent and 10 percent depending on the severity of disease and surgical techniques used (Liu et al., 2017).
Your veterinarian will discuss these risks during your consultation so you can make an informed decision.
Recovery after BOAS surgery
Recovery from BOAS surgery is generally straightforward when post-operative instructions are followed carefully.
Typical recovery recommendations include:
- restricted exercise for approximately 10 days
- feeding soft food during early recovery
- administering prescribed medications
- monitoring breathing closely
- attending scheduled follow-up appointments
Many owners notice an improvement in breathing shortly after surgery, although mild swelling during the first few days is normal.
Research has shown that BOAS surgery can significantly improve respiratory function, exercise tolerance and overall quality of life in brachycephalic dogs (Packer et al., 2015).
Long-term outcomes
Most dogs experience meaningful improvement in breathing after surgery.
Owners commonly report:
- quieter breathing
- improved ability to exercise
- better tolerance of warm weather
- improved sleep quality
- reduced regurgitation or gagging
Early surgical intervention may also reduce the risk of long-term airway damage.
When to seek veterinary advice
If your dog shows signs of breathing difficulty, excessive panting or exercise intolerance, a veterinary assessment is recommended.
Early diagnosis and treatment can significantly improve outcomes.
Click to learn more about BOAS surgery and breathing assessments
References
Liu, N. C., Oechtering, G. U., Adams, V. J., Kalmar, L., Sargan, D. R. and Packer, R. M. A. 2017, ‘Outcomes and prognostic factors of surgical treatments for brachycephalic obstructive airway syndrome’, Journal of Small Animal Practice.
Oechtering, G. U., Pohl, S., Schlueter, C. and Lippert, J. P. 2016, ‘A novel approach to brachycephalic airway syndrome’, Veterinary Surgery.
Packer, R. M. A., Hendricks, A. and Burn, C. C. 2015, ‘Impact of facial conformation on canine health’, PLOS ONE.
Author
Dr Sam Kovac BVSc (Merit)
Member, Royal College of Veterinary Surgeons, UK
Dr Sam graduated with Merit from the University of Sydney in 2011 with a Bachelor of Veterinary Science. In 2013 he became a Member of the Royal College of Veterinary Surgeons in the United Kingdom.
After identifying a gap in the veterinary experience offered to families, he founded Southern Cross Veterinary Clinic in Sydney in 2013, with the goal of delivering innovative veterinary care and improving outcomes for pets and their families.