BOAS surgery is a corrective surgical procedure for Brachycephalic Obstructive Airway Syndrome, a breathing disorder caused by the shortened skull anatomy of flat-faced breeds. It typically involves widening the nostrils, shortening the soft palate, and removing obstructive tissue. Costs in the UK in 2026 are typically £2,000–£4,000.
Which dogs are affected
BOAS most commonly affects:
- French Bulldogs (very high prevalence)
- English Bulldogs
- Pugs
- Boston Terriers
- Cavalier King Charles Spaniels (some lines)
- Shih Tzus
- Pekingese
- Boxers (some)
Severity ranges from mild snoring to life-threatening collapse on a warm day.
Symptoms
Common signs:
- Loud breathing at rest
- Snorting, snoring, gulping
- Inability to exercise without rapid distress
- Heatstroke at moderate temperatures
- Sleep apnoea / disturbed sleep
- Regurgitation (the airway issues compound digestive problems)
- Cyanotic (blue-tinged) gums after exertion
What surgery does
Standard BOAS correction includes some combination of:
- Stenotic nares correction — widening narrow nostrils
- Soft palate resection — shortening an over-long soft palate
- Saccule removal — removing tissue forced into the airway by chronic pressure
Outcomes are generally good if performed early (under 2 years old). Surgery in older dogs is still beneficial but recovery and degree of improvement may be limited.
Whether to choose a brachycephalic breed
The surgery's existence is a reminder: a meaningful percentage of French Bulldogs, English Bulldogs and Pugs cannot breathe normally without surgical intervention. UK welfare bodies (BVA, RCVS, RSPCA, Kennel Club) increasingly publicly advise prospective owners to choose less extreme variants of these breeds, or different breeds entirely.
Related terms
- Brachycephalic, the term for flat-faced breeds
- Heatstroke, high-risk in BOAS dogs
FAQs
Do all French Bulldogs need BOAS surgery? No, but a significant percentage benefit from it. Cambridge University's BOAS grading scheme is the standard for assessment. Ask a vet familiar with brachycephalic medicine to grade your dog.
Is BOAS surgery covered by insurance? Most UK pet insurance covers it as a treatment, but only if BOAS is not classed as pre-existing. This is why insuring early matters for high-risk breeds.
Can BOAS dogs do normal walks? Severe cases struggle even on short walks. Mild cases are mostly fine in cool weather but should be walked carefully in heat. Brachycephalic breeds shouldn't be walked above ~20°C in any case.