CO2 Laser or Traditional BOAS Surgery: Which Is Better for a French Bulldog?

For the soft palate part of BOAS surgery, a CO2 laser has the better track record so far. In the largest comparison published, dogs whose palates were trimmed by laser had fewer serious complications than dogs who had the traditional cut-and-sew method (12.9% versus 20.2%), and older trials found the laser was faster with less bleeding. The bigger factors in how your Frenchie does, though, are her age, her weight, and how far her airway disease has progressed.

A Frenchie mom in our Facebook group posted this week, the night before her boy's BOAS surgery, asking how healing goes and whether anyone had complications. Her surgeon was using a CO2 laser. So here's what the research actually says, and what the first days at home tend to look like.

What is BOAS surgery, exactly?

It's a set of procedures that open up a flat-faced dog's airway. According to the American College of Veterinary Surgeons, the usual pieces are widening pinched nostrils (stenotic nares), shortening the elongated soft palate (called a staphylectomy), and sometimes removing everted laryngeal saccules, all under the same anesthesia. The laser versus traditional question is mostly about the palate step. ACVS lists a scalpel blade, scissors or a CO2 laser as the standard tools for it.

If you want the background on why Frenchies snort and struggle to breathe in the first place, we covered it in BOAS Explained Without the Panic.

Is CO2 laser BOAS surgery better than the traditional method?

On the evidence we have, it looks at least as good and probably safer for the palate. Here are the studies that compared them head to head:

• 413 dogs, four hospitals (JAVMA 2025). Nanda and Hans compared four palate techniques. Serious short-term complications hit 20.2% of cut-and-sew dogs and 12.9% of CO2 laser dogs. Cut-and-sew carried about three times the odds of a major complication compared with the laser.
• 60 dogs, randomized (Veterinary Record 2010). Dunié-Mérigot and colleagues compared CO2 laser, diode laser and electrocautery. The CO2 laser was the fastest and had the least bleeding. The diode laser did worst, with the most complications.
• 20 dogs, randomized (JAVMA 2001). Davidson and colleagues found clinical outcomes were similar between CO2 laser and incisional surgery, but the laser took about 5 minutes versus about 12.
• 60 dogs (Canadian Veterinary Journal 2019). Kirsch and colleagues compared the CO2 laser with a bipolar sealing device and found no difference in complication rates.

Two caveats. The 413-dog study looked back at records, so surgeons chose the technique rather than a coin flip, and that can tilt results. And "laser" is not one thing: the diode laser in the 2010 trial performed worse than the CO2 laser. So the useful question for your vet is which tool, and how many of these they do.

What raises the risk of complications?

The dog matters more than the tool. In that same 413-dog study, older age, a higher body condition score (carrying extra weight), needing emergency surgery, and more advanced laryngeal collapse were all tied to more major complications. VCA Animal Hospitals notes that dogs fixed before two years of age have a better outlook than older dogs. ACVS says the same: prognosis is good for young dogs and poor if laryngeal collapse is advanced.

Our take: if your vet has already flagged BOAS, a planned surgery on a lean young Frenchie beats an emergency one on a struggling older Frenchie every time. That's the one part of the risk you actually control.

What is recovery like after BOAS surgery?

The first 24 hours are the closely watched part. ACVS says swelling in the throat can block the airway right after surgery, which is why dogs are usually kept in the hospital for at least 24 hours, and occasionally need a temporary breathing tube in the neck until the swelling goes down. ACVS also says coughing and gagging afterward are common, so a little hacking at home is expected.

Regurgitation is common too. A 2025 study from the University of Bristol's referral hospital found 31% to 42% of dogs regurgitated within 24 hours of BOAS surgery.

At home, your surgeon's discharge sheet is the rulebook. The owners who answered in our group thread pointed to two things: keep him calm the first week, and offer soft or soaked food while his throat heals. Ask your vet exactly how long to do both.

Call your vet right away if breathing gets louder or harder instead of easier, his gums look pale or blue, or he can't settle and rest.

Will BOAS surgery fix my Frenchie's breathing completely?

It usually makes breathing a lot better, but it doesn't give him a Labrador's airway. A Cambridge study of pugs, French Bulldogs and bulldogs measured breathing before and after surgery: the median BOAS score dropped from 76% to 63%, and a dog at that after-surgery median would still count as clinically affected. VCA recommends a harness instead of a neck collar and keeping BOAS dogs lean for life, and that advice doesn't stop after surgery.

If the cost is the part keeping you up at night, we broke down coverage in Is Pet Insurance Worth It for a French Bulldog?

Want the checklist version?

Drop your email for our one-page Frenchie Longevity Checklist: the everyday habits that keep a Frenchie breathing easy, lean and snoring (the cute kind) for years.

FAQ

Is laser BOAS surgery safer for French Bulldogs?

For the soft palate, the largest comparison so far found fewer major complications with a CO2 laser (12.9%) than with traditional cut-and-sew (20.2%). The dog's age, weight and degree of laryngeal collapse still matter more than the tool.

How long does a French Bulldog stay in the hospital after BOAS surgery?

The American College of Veterinary Surgeons says dogs are usually observed in the hospital for at least 24 hours, because throat swelling can block the airway right after surgery.

Is coughing and gagging normal after BOAS surgery?

Yes, ACVS says post-operative coughing and gagging are common. Call your vet if breathing gets harder instead of easier, or his gums look pale or blue.

What is the best age for BOAS surgery?

Younger is better. VCA notes dogs corrected before two years of age have a better outlook, and older age is linked to more complications.