Guide to Brachycephalic Obstructive Airway Syndrome Surgery and Recovery 

If your dog has recently undergone BOAS surgery, knowing what to expect during recovery can help you provide the care they need to heal comfortably. At Southern Cross Veterinary Clinic, we understand how important it is for your dog to breathe more comfortably and enjoy a better quality of life. 

Brachycephalic Obstructive Airway Syndrome (BOAS) is a respiratory condition that affects many short-nosed dog breeds, including French Bulldogs, Pugs, Boston Terriers, British Bulldogs, Boxers and Shih Tzus. Corrective BOAS airway surgery can improve airflow by addressing anatomical abnormalities that make breathing difficult. 

This guide explains what BOAS surgery involves, how our minimally invasive surgical approach works, what to expect during recovery and how to care for your dog at home. 

If you are still exploring your options, visit our BOAS surgery page to learn more about treatment at Southern Cross Veterinary Clinic in Sydney.

What is Brachycephalic Obstructive Airway Syndrome (BOAS)? 

Brachycephalic Obstructive Airway Syndrome is a condition associated with the shortened skull shape of brachycephalic dogs. Their facial structure can cause abnormalities in the upper airway, restricting airflow through the nose and throat. 

Common anatomical abnormalities associated with BOAS include: 

• Stenotic nares, which are unusually narrow nostrils that restrict the amount of air a dog can breathe in. 

• An elongated soft palate, where excess soft tissue at the back of the mouth partially obstructs the entrance to the airway. 

• Everted laryngeal saccules, where soft tissue inside the larynx turns outwards and contributes to airway obstruction. 

• Laryngeal collapse, which can develop as chronic breathing difficulties place increased strain on the airway. 

• Other anatomical abnormalities, including a narrow windpipe or additional tissue within the upper airway. 

Not every dog has all these abnormalities, and the severity of BOAS varies between individuals. The condition can become more problematic over time as the effort required to breathe contributes to inflammation and further obstruction. 

According to Cornell University College of Veterinary Medicine’s guide to BOAS, affected dogs may experience noisy breathing, exercise intolerance, difficulty breathing and, in severe cases, collapse. 

If your dog snores heavily, struggles to exercise or appears to work harder than normal to breathe, it is worth arranging a veterinary assessment. Loud breathing is not something that should automatically be considered normal simply because a dog has a flat face. 

How does minimally invasive BOAS surgery at Southern Cross Vet aid recovery? 

At Southern Cross Veterinary Clinic, our approach to BOAS surgery focuses on correcting the anatomical problems contributing to restricted airflow while minimising unnecessary tissue trauma. 

Our minimally invasive technique uses a specialised instrument called a Caiman handpiece, which uses advanced energy technology to seal tissue during selected parts of the procedure. This allows the surgeon to remove excess tissue with the aim of minimising bleeding, bruising and irritation at the surgical site. 

Reducing tissue trauma can support a more comfortable recovery. The technique also avoids the need for irritating sutures at the back of the throat for the soft palate procedure performed using this method. Sutures may still be required for other parts of the operation, such as nostril widening. 

The specific surgical approach depends on your dog’s anatomy and the abnormalities identified during assessment. 

Shorter time under anaesthesia 

Minimising operating time is another consideration during BOAS airway surgery. Our technique is designed to reduce the time needed for selected surgical steps, helping limit the duration of anaesthesia where possible. 

Brachycephalic dogs require particular care during anaesthesia because their narrowed airways can make breathing and recovery more challenging. A shorter procedure does not eliminate these risks, which is why appropriate anaesthetic planning and close monitoring remain essential. 

Dedicated veterinary anaesthetist support 

Every BOAS surgery at Southern Cross Veterinary Clinic is supported by a dedicated veterinary anaesthetist who focuses on monitoring your dog throughout the anaesthetic and recovery process. 

This includes monitoring vital signs and responding to changes that may arise during the procedure. Having a professional dedicated to anaesthetic care is an important part of our approach to managing the additional risks associated with brachycephalic patients. 

Read more about our veterinary anaesthetist support for surgical procedures. 

Can my dog go home on the same day? 

Many dogs undergoing our minimally invasive BOAS procedure can return home on the evening of surgery, provided they have recovered appropriately and the veterinary team considers it safe. 

However, not every patient will be suitable for same-day discharge. Dogs with more severe airway disease, significant swelling, breathing difficulties or other complications may need extended monitoring or hospitalisation. 

Our priority is to ensure that each dog is stable enough to continue recovering at home safely. 

What is involved in BOAS airway surgery for dogs? 

BOAS surgery is tailored to the abnormalities affecting each dog’s breathing. Depending on the findings, one or more surgical procedures may be recommended.

1. Nostril widening (stenotic nares correction)

Stenotic nares are abnormally narrow nostrils that restrict airflow through the nose. During surgery, the veterinarian removes a small amount of tissue to widen the openings and improve airflow. 

Sutures may be placed to support healing. These are generally designed to dissolve over time, depending on the technique used. 

The aim is to make it easier for your dog to breathe through their nose, reducing the effort required to draw air into the respiratory tract. 

Dr Sam uses two specific techniques for nares surgery: vestibuloalarplasty (AKA Trader’s technique) and wedge resection.  The former does not require sutures, but does have a more prolonged and involved recovery, however often prodcued more pronounced widening. Dr Sam will have a discussion with you on pros and cons of each procedure when deciding whether Trader’s or a wedge resection is most appropriate.

2. Soft palate surgery

This is the bulkiest and most important part of the procedure.. The soft palate is the soft tissue at the back of the roof of the mouth. In some brachycephalic dogs, it is too long or thick relative to the available space, obstructing airflow into the larynx and causing a ‘vacuum’ phenomenon or ‘dynamic airway disease’ where each breath in causes collapse of the soft tissues due to too much tissue being in the way. 

During BOAS soft palate surgery, the veterinarian assesses the palate and removes or reshapes excess tissue where necessary. At Southern Cross Veterinary Clinic, our minimally invasive technique uses the Caiman handpiece for selected soft palate procedures. 

The goal is to reduce obstruction while preserving enough tissue for normal swallowing and airway function. Dr Sam routinely removes most, if not all, of the soft palate structure, totally removing this obstructive aspect. 

The aim is to do the surgery ONCE, and not need repeat surgeries to trim more soft palate. Only experience and skill can achieve this.

3. Correction of everted laryngeal saccules

Laryngeal saccules are small pockets of tissue within the larynx. Persistent negative pressure from difficult breathing can cause them to turn outwards into the airway, contributing to obstruction. 

If these tissues are significantly restricting airflow, surgical removal may be considered. However, the procedure is not necessary in every patient. The decision depends on the degree of obstruction and the veterinarian’s assessment of the airway.

4. Tonsils

Dr Sam routinely removes the tonsils using our advanced minimally invasive energy sealing technique in almost every BOAS case to reduce obstruction and increase airlflow by an additional 25% on averahe 

5. Other airway abnormalities

Some dogs have additional abnormalities, such as a narrow windpipe or changes associated with laryngeal collapse. These may require further investigation or a different treatment approach. 

Not every abnormality can be corrected through standard BOAS surgery. Your veterinarian will discuss the findings, the available options and the likely benefits and limitations of treatment. 

For more information about our approach, visit the Southern Cross Vet BOAS surgery page. 

How to help your dog recover after BOAS surgery 

The recovery period is an important part of treatment. Following your veterinary team’s instructions helps protect the surgical sites, manage discomfort and reduce the risk of complications. 

The following guidance reflects our usual post-operative care approach. Always follow the individual discharge instructions provided for your dog, as recommendations may differ depending on the procedures performed.

1. Protect the surgical site around the nose

If your dog has undergone nostril widening, the surrounding skin may be sensitive while it heals. 

Where specifically instructed by your veterinarian, apply a thin layer of Vaseline to the external nasal incision lines at least three times daily. This helps protect the skin from irritation caused by frequent sniffing. 

Apply it gently and only to the areas identified by your veterinary team. Do not put Vaseline inside your dog’s nostrils or apply other creams, antiseptics or ointments unless advised. 

Contact your veterinarian if you notice increasing redness, discharge, bleeding, wound separation or significant swelling.

2. Restrict exercise for the first 10 days

During the initial 10 days after surgery, keep your dog calm and avoid vigorous activity. Running, jumping, rough play and overexcitement can increase breathing effort and disturb healing tissues. 

For the first 10 days, our usual guidance is to: 

• Keep walks short and on a lead. 

• Avoid strenuous off-leash exercise. 

• Walk during cooler parts of the day, ideally before 10 am or after 4 pm, depending on the weather. 

• Avoid extreme heat, humidity and very cold conditions. 

• Keep your dog in a calm, comfortable environment. 

Use a harness rather than a collar to avoid putting pressure on the neck. Even after recovery, avoiding overheating and excessive exertion remains important for dogs affected by BOAS.

3. Give all prescribed medication as directed

Your dog may be prescribed medication to help manage pain and inflammation, reduce nausea or vomiting, control stomach acidity and support recovery. 

Depending on your dog’s needs, this may include: 

• Anti-inflammatory or pain-relieving medication. 

• Antiemetics to help control nausea and vomiting. 

• Medication to reduce stomach acidity and help manage regurgitation. 

• Antibiotics where indicated. 

• Sedation where appropriate to help keep your dog calm during recovery. 

Not every dog requires every medication. The treatment plan is individualised according to the procedures performed and the patient’s medical needs. 

Give medication exactly as prescribed. Do not change doses, stop treatment early or administer additional medication without checking with your veterinarian. 

Vomiting and regurgitation are particularly important to monitor after BOAS surgery because they can irritate the surgical site and may increase the risk of material entering the lungs.

4. Adjust your dog’s diet during recovery

Follow the feeding instructions provided at discharge. Your veterinary team may recommend smaller, more frequent meals and food with a softer texture if your dog is experiencing throat discomfort. 

Avoid hard, dry foods that may irritate the back of the throat during the initial recovery period if your veterinarian has advised this. Our usual guidance is also to avoid raw meat for the first 10 days after surgery because of the potential for foodborne pathogens. 

Make sure your dog has access to water as instructed. Contact your veterinary team if your dog struggles to swallow, repeatedly regurgitates, vomits or cannot keep food or water down. 

Do not force food or water if your dog is having difficulty swallowing or breathing. 

5. Ice cream!

Yes, Dr Sam recommends lactose-free ice cream and frozen yoghurt in the recovery period to cool and reduce inflammation within the throat.  

6. Attend both post-operative appointments

Follow-up examinations allow the veterinary team to check healing, assess breathing and identify any concerns early. 

At Southern Cross Veterinary Clinic, our usual post-operative schedule includes: 

• An initial follow-up approximately 3 days after surgery. 

• A second follow-up around 10 days after surgery. 

Your dog’s individual plan may differ. Attend all recommended appointments, even if your dog seems comfortable and is breathing more easily.

7. Know when to seek urgent veterinary care

Dr Sam is ALWAYS in contact with his post op patients daily, so please raise concerns with him.  

Some mild coughing, gagging or throat irritation may occur during recovery, but worsening symptoms should never be ignored. 

Seek urgent veterinary attention if your dog develops: 

• Increasing difficulty breathing or pronounced breathing effort. 

• Blue, grey or unusually pale gums or tongue. 

• Collapse, severe weakness or loss of consciousness. 

• Rapidly worsening swelling around the throat or surgical area. 

• Repeated vomiting or regurgitation, particularly alongside breathing changes. 

A dog experiencing severe breathing difficulty needs immediate veterinary attention. Do not wait for a scheduled follow-up appointment. 

 How long does it take for a dog to recover from BOAS surgery? 

The initial recovery period generally involves around 10 days of restricted activity and careful monitoring. However, complete recovery varies according to the procedures performed, the severity of the original airway obstruction and the individual dog’s response to surgery. 

Some dogs show improvements in breathing relatively quickly, while swelling and irritation may take longer to settle. In more complicated cases, additional monitoring or treatment may be required. 

It is important to remember that BOAS surgery improves airflow by correcting specific anatomical abnormalities. It does not necessarily eliminate every respiratory problem, particularly when a dog has advanced airway changes or other underlying conditions. 

Your veterinarian will advise when your dog can gradually return to normal activity. 

Learn more about BOAS surgery 

If you are considering treatment for your dog, these resources may help you understand the condition and your options: 

• BOAS surgery at Southern Cross Veterinary Clinic 

• Meet Dr Sam Kovac, founder of Southern Cross Veterinary Clinic 

• Understanding BOAS surgery costs 

• Pug BOAS and airway surgery 

• The 10 most common French Bulldog health problems 

• Watch our BOAS-related video on YouTube 

For further background, Cornell University College of Veterinary Medicine and the American College of Veterinary Surgeons provide additional information about BOAS, surgical treatment and potential complications. 

Frequently asked questions about BOAS surgery 

What is brachycephalic obstructive airway syndrome in dogs? 

Brachycephalic Obstructive Airway Syndrome, or BOAS, is a respiratory condition associated with the shortened skull and upper airway anatomy of flat-faced dogs. It can cause narrowed nostrils, an elongated soft palate and other abnormalities that restrict airflow. Commonly affected breeds include French Bulldogs, Pugs, British Bulldogs and Boston Terriers. 

What is BAS surgery? 

BAS surgery generally refers to brachycephalic airway syndrome surgery. The term is often used interchangeably with BOAS surgery, which stands for Brachycephalic Obstructive Airway Syndrome surgery. These procedures aim to improve airflow by correcting anatomical abnormalities contributing to breathing difficulties. 

How do I tell if my dog has an airway obstruction? 

Signs can include noisy breathing, persistent snoring while awake, snorting, excessive panting, exercise intolerance, difficulty breathing, gagging and regurgitation. Severe signs include blue or grey gums, collapse or pronounced breathing effort. If your dog is struggling to breathe, seek emergency veterinary care immediately. 

How is BOAS treated? 

Treatment depends on the severity of the condition and the abnormalities present. Mild cases may benefit from weight management, avoiding overheating, controlled exercise and using a harness rather than a collar. Dogs with significant anatomical obstruction may require corrective surgery to widen the nostrils, shorten an elongated soft palate or address other obstructive tissue. 

What BOAS treatment options are available for dogs? 

Treatment options include conservative management for suitable mild cases and surgery for dogs whose anatomical abnormalities significantly restrict airflow. Your veterinarian may recommend a physical examination and further assessment of the airway before deciding which treatment is appropriate. Surgery may involve one or several procedures, depending on the dog’s needs. 

What is involved in BOAS airway surgery for dogs? 

BOAS airway surgery may involve widening narrow nostrils, shortening or reshaping an elongated soft palate and removing obstructive tissue such as everted laryngeal saccules when indicated. The exact procedures depend on the dog’s anatomy and the severity of the obstruction. Anaesthetic planning, close monitoring and post-operative care are important parts of the process. 

How long does BOAS surgery take to heal? 

Many dogs have an initial recovery period of approximately 10 days, during which exercise must be restricted and the surgical sites protected. However, the time required for swelling to settle and breathing to improve varies. Your veterinarian will assess your dog’s progress and advise when normal activity can gradually resume. 

Are dogs in pain after BOAS surgery? 

Some discomfort, inflammation and throat irritation can occur after BOAS surgery. Your veterinarian will prescribe appropriate pain relief and other medication according to your dog’s needs. If your dog appears increasingly uncomfortable, refuses food, repeatedly vomits or develops worsening breathing difficulties, contact your veterinary team promptly. 

How risky is BOAS surgery? 

BOAS surgery can improve breathing and quality of life, but it is not risk-free. Brachycephalic dogs have increased risks associated with anaesthesia and recovery because their airways are already compromised. Potential complications include swelling, bleeding, breathing difficulties and aspiration pneumonia. Appropriate patient assessment, anaesthetic monitoring and post-operative care help manage these risks. 

What is the recommended anaesthetic protocol for brachycephalic dogs? 

There is no single anaesthetic protocol that is appropriate for every brachycephalic dog. The plan should be tailored to the patient’s airway anatomy, respiratory function, general health and the procedure being performed. Careful airway management, monitoring during anaesthesia and close observation during recovery are particularly important. At Southern Cross Veterinary Clinic, a dedicated veterinary anaesthetist supports every BOAS procedure. 

What is the success rate of BOAS surgery? 

There is no single success rate that applies to every dog. Outcomes depend on the severity of BOAS, the abnormalities being corrected, the dog’s age and general health, and whether secondary changes such as laryngeal collapse have developed. Many dogs experience meaningful improvements in breathing and exercise tolerance, but surgery cannot guarantee normal breathing or eliminate every airway problem. 

What are the long-term complications that can occur after BOAS surgery? 

Some dogs continue to experience breathing difficulties after surgery, particularly if they have advanced airway changes or additional abnormalities that cannot be fully corrected. Other possible complications include persistent airway obstruction, scar tissue, swallowing or regurgitation problems and the need for further treatment. Regular veterinary reviews are important if symptoms persist or return. 

Can a dog’s soft palate grow back after surgery? 

The portion of the soft palate removed during surgery does not simply grow back to its original length in the usual sense. However, healing, scar tissue, residual excess tissue or other ongoing airway abnormalities can contribute to persistent or recurring symptoms. If noisy breathing or other signs continue after surgery, your veterinarian can assess whether further investigation or treatment is needed. 

Where can I find a BOAS specialist near me? 

If you are searching for a BOAS specialist near you, look for a veterinary team with experience assessing brachycephalic airway disease, performing corrective surgery and managing the anaesthetic and post-operative risks associated with these patients. Ask about the surgeon’s experience, monitoring arrangements, recovery support and follow-up care. 

Where can I get BOAS surgery for my dog in Sydney? 

Southern Cross Veterinary Clinic provides BOAS surgery in Sydney, with procedures performed by our founder, Dr Sam Kovac. We use a minimally invasive surgical approach and provide dedicated veterinary anaesthetist support. Visit our BOAS surgery service page to learn more about the service and arrange an assessment. 

Can I get BOAS surgery for my Pug? 

Yes. Pugs are among the breeds commonly affected by BOAS. However, the appropriate treatment depends on the individual dog’s airway anatomy, symptoms and overall health. Read more about Pug BOAS and airway surgery or arrange a veterinary assessment to discuss your dog’s needs. 

How much does BOAS surgery cost in Sydney? 

The cost of BOAS surgery depends on the procedures required, the patient’s needs and the care included in the treatment plan. Southern Cross Veterinary Clinic provides information about its service and pricing on our BOAS surgery cost page. We encourage pet owners to understand what is included in a quote and to discuss any questions with the veterinary team before proceeding. 

About Dr Sam Kovac 

Dr Sam Kovac is the founder of Southern Cross Veterinary Clinic and has a particular interest in minimally invasive surgery and brachycephalic health. He has performed hundreds of BOAS surgeries and focuses on helping dogs with breathing difficulties enjoy a better quality of life. 

Learn more about Dr Sam Kovac and his veterinary experience. 

At Southern Cross Veterinary Clinic, we believe advanced veterinary medicine should go hand in hand with compassionate, family-focused care. Our aim is to help you understand your dog’s condition, the available treatment options and the care they need throughout recovery. 

This article is intended as general educational information and does not replace an individual veterinary examination or the post-operative instructions provided by your treating veterinarian. 

Dr Sam Kovac BVSc (Merit)

Dr Sam followed his dream of becoming a veterinary surgeon which began at age three. Since then, he has developed a strong interest in oncology, internal medicine and animal behaviour. Dr Sam continues his passion for providing the most up-to-date care to his patients and their two-legged family.