Stenotic Nares Laser Surgery FAQ

    What is Stenotic Nares?

    Stenotic nares in a brachycephalic dog (left) compared to the open nostrils of a mesaticephalic dog (right).

    Dog and cat brachycephalic breeds may have difficulty breathing through their nose. This may be due to stenotic nares, meaning narrow nostrils.[1] This can be corrected as an outpatient procedure performed with an Aesculight carbon dioxide (CO2) laser.

    What is Brachycephalic Obstructive Airway Syndrome (BOAS)?

    Brachycephalic Obstructive Airway Syndrome is a genetic disorder that compromises the upper airway most commonly in flat-faced/short-headed (brachycephalic) dog and cat breeds.[2] Upper airway abnormalities correlated with BOAS include stenotic nares, an elongated soft palate, laryngeal collapse, extended nasopharyngeal turbinates, and others. A dog or cat with BOAS could be affected by one or more of these abnormalities.[3]

    What Dog and Cat Breeds may be affected by BOAS?

    brachycephalic dog bulldogDog Breeds Affected By Brachycephalic Airway Obstructive Syndrome and Stenotic Nares include:

    • Affenpinscher
    • American Staffordshire Terrier
    • American Bulldog
    • Boston Terrier
    • Boxer
    • Brussels Griffon
    • Bulldog
    • Bullmastiff
    • Cane Corso
    • Chihuahua (apple-headed)
    • Dogue de Bordeaux
    • English Mastiff
    • French Bulldog
    • Griffon Bruxellois
    • Japanese Chin
    • King Charles Spaniel
    • Lhasa Apso
    • Neapolitan Mastiff
    • Newfoundland
    • Olde English Bulldogge
    • Pekingese
    • Pug
    • Rottweiler
    • Shar Pei
    • Shih Tzu
    • Tibetan Spaniel
    • Valley Bulldog

    brachycephalic catCat Breeds Affected By Brachycephalic Airway Obstructive Syndrome and Stenotic Nares:

    • British Shorthair
    • Burmese
    • Exotic Shorthair
    • Himalayan cat
    • Persian cat
    • Scottish Fold

    What Causes Brachycephalic Obstructive Airway Syndrome and How Can It Be Avoided?

    Brachycephalic dog and cat breeds are born with these airway deficiencies, so they cannot be prevented, only treated, during the animal’s lifetime. BOAS is caused by selective breeding over hundreds of years. A flatter faced dog or cat is often considered cuter and it is bred this way without consideration for the pets’ overall health. Because the face is flattened it often does not allow for a sufficient airway.

    Selective breeding practices predispose brachycephalic dogs and cats to the potential extreme conditions of BOAS. These animals are dependent on their owners to provide surgical solutions to improve their quality of life.  Without laser surgery correction of this condition, these brachycephalic breed animals cannot avoid the associated breathing difficulties of BOAS.

    What Are Some Signs of Stenotic Nares?

    boas stenotic nares pugSome signs of stenotic nares and BOAS for pet owners to look for include:[4]

    • Distressed breathing – panting and overworking to breathe even while at rest.
    • Abnormal breathing noises – such as constant snorting or snoring sounds, awake and asleep
    • Unwillingness or inability to exercise
    • Overheating – an inability to control their body temperature
    • Fainting – even after brief or light exercise

    Some pet owners are unaware that these signs negatively affect their pet’s quality of life. They may think that these symptoms are normal or even cute and desirable.

    Is Stenotic Nares Surgery Necessary?

    Owners of brachycephalic cat and dog breeds are often unknowingly putting their pets’ health at risk and not seeking life-changing treatment because they consider their pets’ breathing difficulties to be ‘normal’ for the breed.[4] The ability to breathe adequately directly affects the overall health of the pet. Not treating stenotic nares when it is present can lead to less exercise, obesity, a shorter lifespan, and a lower quality of life.

    What Is Stenotic Nares Aesculight Laser Surgery?

    Aesculight Stenotic Nares Surgery

    Stenotic nares Aesculight laser surgery. Photo courtesy of Daniel Core, DVM.

    The Aesculight CO2 Laser is used to excise tissue covering or obstructing the nostrils to allow for increased airflow, thereby reducing the effort needed to breathe.[5]

    What Are the Advantages of Aesculight Stenotic Nares Laser Surgery?

    laser stenotic nares results

    Laser stenotic nares surgery before and after. Photo courtesy of Daniel Core, DVM.

    Aesculight CO2 Laser Stenotic Nares Method

    The use of an Aesculight CO2 laser to correct stenotic nares and to perform other soft-tissue orofacial procedures offers many benefits over conventional methods such as scalpels, scissors or electrosurgical units. Some of these advantages include:

    • No Bleeding: CO2 laser surgical repair of stenotic nares is bloodless, which gives veterinary surgeons a clearer view of the surgical area, allowing for the most precise surgery.
    • No Sutures Required: When this procedure is performed with a CO2 laser no suturing is required because the laser seals blood vessels and capillaries.
    • Less Pain: The CO2 laser seals nerve endings and lymphatics, resulting in less pain and swelling. Pets will experience more comfortable post-operative recovery compared to conventional surgical methods.
    • Reduced risk of infection: The CO2 laser efficiently kills bacteria as it cuts, producing a sterilizing effect.
    • Better Aesthetic Results: Using a CO2 laser brings an excellent aesthetic result. There is reduced scarring due to decreased activation of myofibroblasts at the wound margin in comparison with scalpel surgery.
    • Quicker recovery time: Because CO2 laser surgery has less pain and less swelling, it will often allow the patient a faster recovery after the surgery.

    Conventional Stenotic Nares Surgical Method

    Conventional methods to perform stenotic nares surgery use a scalpel, which makes the procedure more difficult and riskier due to hemorrhage.

    Due to an obstructed view of the surgical site through bleeding caused by the scalpel, the veterinary surgeon must be especially careful when trying to achieve symmetry of the nostrils.[5]

    A scalpel procedure often requires three to four sutures on both nostrils.[6]

    Because it is a scalpel procedure it may leave scars.[5]

    What Is Recovery like from Stenotic Nares Aesculight Laser Surgery?

    Recovery from Aesculight CO2 laser surgery is most often quicker and more comfortable than that of scalpel surgery.  There is minimal postoperative care required. The pet is usually discharged the same day as the surgery with immediately noticeable improved breathing. If the nostrils become overly dry an ointment may be applied.[5]

    Stenotic Nares Laser Surgery Is Best Performed at What Age?

    Brachycephalic dog and cat breeds that have stenotic nares have it from birth. A good time to perform an Aesculight CO2 laser stenotic nares correction is at a young age, such as during a routine spay or neuter procedure, without adding a significant increase in anesthesia time.[5] Other BOAS abnormalities, such as an elongated soft palate and laryngeal collapse, could also be assessed and treated at this time.

    Early surgical intervention of stenotic nares is best. Stenotic nares surgery can decrease the severity and even eliminate clinical BOAS.[5] If left untreated stenotic nares can lead to severe health problems.

    How Can I Find an Aesculight Veterinarian?

    If you are looking for local veterinarians who perform Aesculight CO2 laser surgery, please use our Locate a Veterinarian form.

    Further Reading

    Introduction to Brachycephalic Obstructive Airway Syndrome (BOAS) Research Group at the University of Cambridge.


    1. Ruaux C. The Respiratory System. In: Small Animal Pediatrics. Elsevier, 2011; 328-339.
    2. Packer RMA, Henricks A, Tivers MS, Burn CC. Impact of Facial Conformation on Canine Health: Brachycephalic Obstructive Airway Syndrome. PLoS One. 2015; 10(10).
    3. Recognition and Diagnosis. In BOAS Research Group at the Department of Veterinary Medicine at the University of Cambridge. www.vet.cam.ac.uk. Retrieved 2019-04-17.
    4. Worrying numbers of “short-nosed” dog owners do not believe their pets to have breathing problems, despite observing severe clinical signs. Royal Veterinary College University of London. www.rvc.ac.uk. Retrieved 2019-04-17.
    5. Core DM. CO2 laser allows bloodless repair of stenotic nares. Veterinary Practice News. 2013;10:32-33.
    6. Hedlund CS. Surgery of the Upper Respiratory Systems. In: Fossum TW (Ed). Small Animal Surgery, 3rd ed, St. Luis, MO: Elsevier/Mosby, 2007; 817–866.