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Blog

Before elective airway surgery: what every adolescent pug owner should know

6/28/2026

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There is a current trend among veterinarians to recommend popular cosmetic surgeries. BOAS specialists we have consulted at Pug Nationals never recommend these surgeries y less the pug is in severe distress, passing out, unable to take in air. 

“My veterinarian is recommending airway surgery when my puppy is being spayed or neutered. What should I do?”

First, get a second opinion. Second, if you elect to do a surgery know the risks and only use a specialist.


There isn’t a single answer that fits every Pug.
Some Pugs genuinely benefit from airway surgery. Others never need it. The key is making the decision based on your individual dog’s health and function—not simply because they belong to a brachycephalic breed. But remember that your pug’s head is not fully developed until approximately age 2 and scar tissue can often cause more complications.

The Adolescent Pug
Around 8 to 18 months of age, many Pugs go through what breeders affectionately call the “teenage stage.”

They may suddenly appear taller, leggier, or less substantial than they did as puppies. Their expression often changes, and many have not yet developed the broad head, deep chest, and mature appearance expected of an adult Pug.
Experienced preservation breeders have watched generations of Pugs mature and know that many continue developing well into their second year. While the skeleton is approaching maturity, the overall appearance of the head and body continues to “finish” with age.
This is one reason we encourage owners not to judge an adolescent Pug’s long-term structure too quickly.

Not Every Pug Needs Airway Surgery
Unfortunately, there is sometimes a misconception that every brachycephalic dog automatically requires corrective airway surgery.

That simply isn’t true.

Airway surgery should be recommended because a dog has documented airway disease—not because of its breed alone.

Veterinarians evaluate many factors, including:
  • breathing effort
  • exercise tolerance
  • heat tolerance
  • sleep quality
  • airway examination
  • overall clinical signs

Some dogs clearly benefit from surgery.

Others breathe comfortably throughout their lives without needing any corrective procedures.

What About Stenotic Nares?
True congenital stenotic nares are present from birth.

However, breathing function involves much more than nostril shape alone. The soft palate, larynx, trachea, body condition, and several other structures all contribute to how well a dog breathes.

This is why a decision about surgery should never be based solely on appearance.

Ask Questions Before Saying Yes
If airway surgery is recommended, don’t hesitate to ask:
  • What specific problem has been identified?
  • What diagnostic examination supports this recommendation?
  • Is my dog showing clinical signs, or is this preventative?
  • What improvement is expected?
  • What are the risks of waiting?
  • Would referral to a board-certified veterinary surgeon be appropriate?

A thoughtful veterinarian should welcome these questions.

Facial Wrinkles
The Pug’s facial wrinkles are one of the breed’s defining characteristics.

Routine cleaning of the nose roll is a normal part of Pug ownership and helps prevent irritation and skin infections.

Occasionally, a dog develops medical problems such as chronic dermatitis or corneal irritation that truly require surgical correction. In those situations, surgery can greatly improve comfort and quality of life.

However, surgery should address documented disease—NEVER REMOVING ENTIRE NOSE ROLL, and only small sections which are run in on the eye causing corneal ulceration. Surgery should NEVER replace routine grooming.

Our Philosophy

At Pickwick Pugs, we breed for health, soundness, and preservation of the historic Pug.
Every breeding dog undergoes extensive health testing, and we carefully select for dogs with good respiratory function as well as correct breed type.

Because every dog is different, we encourage owners to make surgical decisions thoughtfully, using objective medical findings rather than assumptions based solely on breed.

If one of our puppy owners is advised to pursue elective airway surgery, we are always happy to discuss the recommendation with you, review your dog’s history, and, when appropriate, encourage consultation with a veterinary specialist before permanent procedures are performed.

You’re Never Alone
One of the advantages of purchasing a puppy from a preservation breeder is that your support doesn’t end on Gotcha Day.

If your veterinarian recommends airway surgery—or any major procedure—we encourage you to contact us.

We may not replace your veterinarian, but we know your dog’s pedigree, the health history of generations of relatives, and the developmental patterns we’ve observed over many years of breeding Pugs.

Together, we can help ensure every decision is made with one goal in mind:

A long, healthy, active life for your Pug.

If you are the proud parent of a Pug puppy approaching their first birthday, you are likely right in the middle of the "awkward teenage phase." Their legs get a little long, their bodies stretch out, and their facial features are in a state of rapid transition.

Unfortunately, this exact timeframe is also when many well-meaning veterinarians start suggesting preemptive airway or cosmetic surgeries.

There is a massive, growing trend in the veterinary industry right now surrounding brachycephalic breeds. Clinics are increasingly pushing aggressive, multi-procedure "preventative" surgical packages—often trying to tack them onto a routine spay or neuter appointment around 10 to 12 months of age.

Before you schedule an elective procedure to have your dog's nostrils widened or face structurally altered, let’s talk about the biological reality of how a preservation-bred Pug grows, and why patience is almost always the best route.
 
Our Policy & Your Safety Net
Because we breed strictly for health, soundness, and adherence to the breed standard, we fiercely protect our puppies' physical structure.
If your puppy had stenotic nares our vet would have diagnosed this and we would have told you. In fact, we would not have sold the puppy. But if you do notice your pug struggling to breath, making loud honking noises (which are not related to kennel cough or seasonal issues), passing out, please let us know. We are always here to serve as your lifelong resource and your dog's ultimate advocate. If you ever have a question about your Pug’s breathing, grooming, or changing features, skip the Google panic and text us first. Let's let those beautiful heads grow up before we let anyone change them!

A Great Time to Review the Breed Standard
If you want to better understand the beautiful engineering behind your dog's features, now is the perfect time to read through the official AKC Pug Breed Standard.

Taking a look at the standard helps you understand why we work so hard to preserve characteristics like the signature, large facial wrinkles, the wide, open expression, and that compact, square, "multum in parvo" (much in little) silhouette. And, yes, a nose roll! When you know what a historically correct, preservation-bred Pug is supposed to look like, it becomes much easier to see the difference between a natural, well-proportioned breed feature and an actual health defect.

Head over to the Illustrated Breed Standard to explore the blueprint of the breed, and let’s keep celebrating everything that makes these dogs so incredibly special, inside and out!

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    Author

    Amy - pug lover, concert pianist, composer, lecturer, teacher, adjudicator, PawTree Pet Pro, breeder/owner/trainer at Pickwick Pugs along with her husband, Dr. Jeff McLelland - pug lover, concert organist, choir director, former college professor.

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Owners - Jeff and Amy McLelland

Located outside of Birmingham, Alabama, USA


Author of The Pug Bible

Author of The Pug Puppy Primer

Petpro with PawTree (Natural foods, treats, supplements, and other pet products developed by Veterinarians and PhDs in Animal Science and Pet Nutrition)


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We feed exclusively PawTree and Nuvet Daily Vitamin
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Best of Breed, CH Pickwick's Peachtree Hill Country Mighty Macintosh, TKN - our first bred-by-champion.
Bumi was star student at his puppy class today and has been pretty much bomb-proof in the world so far. You definitely set him up for success!"

"You do such a good job training/preparing them. Rosalina is the best trained dog in this house...everyone at work is always blown away how incredible she is ... Socialization, confidence, obedience ... And, well, she’s really pretty." (Vet Tech, mom, loving pug owner)

"The vet was impressed that his nostrils were completely open."

"So many people at the festival were asking where did you get such a beautiful pug from and we said from an amazing breeder in Alabama, Pickwick Pugs"


"He [Louie, out of the Beatrix Potter litter] is by far the most athletic & strongest of any other pugs we’ve had. He’s 18.5 lbs of muscle! I’m sure there are genetics involved, but we also followed your advice with the diet, fish oil, supplements etc. If we had the time, I bet he’d be a champion at agility. We love everything about him!!"
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Lilibeth, (CH Pickwick's Show the World How to Smile), our 6th AKC Champion
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Amy at The Pug Dog Club of America National Specialty

Contact Us - Inquiry Application Form

Puppy/Pug Questionnaire Application
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Amy, AKC Breeder of Merit, with CH Pickwick's Oh, the Places You'll Go (Cindy) finishing her championship out of the puppy class.
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Lilly, a Pickwick Best in Show winner
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A Pickwick puppy graduating from Star Puppy Academy just before "gotcha day".
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How to speak Puglish with a heavy accent: It’s a language where no means sing me a song, and come here means gravity has doubled and I must now become a flat, vocal pancake. ;) 
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      • CH Pickwick's Worship the Ground I Walk On
      • CH Pickwick's Casanova in Disguise
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      • CH Pickwick's Oh the Places You'll Go
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      • Pickwick's Judge of Your Own Happiness
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        • Pickwick's Watching the Stars Align
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      • Temperament Evaluation Form >
        • Avid Dog Temperament Evaluations
      • Conformation Evaluation Form
    • Puppy Blog >
      • Scenes from Puppy Nursery
    • Prospective Litters >
      • Shakespeare Litter
      • French Pastry Litter
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