What It Means To Be A Flat-Faced Dog?

Two Pugs Flat Faced Dogs

Have you ever heard of the Brachycephalic dog breeds?  They can be very challenging when it comes to caring for them, but that still doesn’t stop these pups from being among the most popular breeds in the world. In this article, we’ll try to explain what the brachycephalic syndrome is and which steps you should take if you’re an owner of a dog who has it. Read on!

What is Brachycephalic Syndrome in Dogs?

Otherwise known as pups with “crushed” faces, the brachycephalic dogs are a group of breeds that are very popular around the world. Some of these breeds include the following ones – Boston Terrier, Pekingese, Japanese Chin, Pug, Brussels Griffon, Shih Tzu, Lhasa Apso, Boxer, Bulldog, and others. Just in the United States alone, the sheer amount of registrations for English and American Bulldogs has gone up almost 70% over the last decade. The things are even more staggering when it comes to French Bulldog – the breed has enjoyed an increase of 476%!

French Bulldog Puppy in men's arms

But what exactly is the thing that makes them “Brachycephalic”? This syndrome refers to their broad and flat skull shape, looking opposite of skull shapes of Greyhounds or other long-nosed breeds. Therefore, a dog with this type of a skull looks as if his head was compressed from front to back. This causes them to have flatter, rounder faces, with big eyes and a more human-like appearance which just might be the thing that makes them so popular. In the extreme cases, it might even appear that these breeds don’t have a nose at all, which makes him look entirely different than, say, a Labrador or a German Shepherd.

These dogs are among the most intelligent and fun-loving pets that a person can have, as they’re packed with energy and personality and can indeed become a person’s best friends. However, sharing the life with such a pooch requires some extra knowledge and skill – one has to know about all those things that make them so different than the other dog breeds. They have some specific needs, especially when it comes to keeping them healthy once they’re old. Anyone considering owning a brachycephalic pup should be aware of some critical factors and problems – so let’s get into it.

Which Breeds are Brachycephalic?

Let’s have a look at the list of breeds with brachycephalic dog skull, splitting it into three categories based on their sizes:  

  • Small Breeds

Most breeds that are brachycephalic are quite small and portable, weighing no more than mere 20 pounds. These would include the Boston Terrier, the Japanese Chin, the Lhasa Apso, the Brussels Griffon, the Cavalier King Charles spaniel, the Pug, the Pekingese, the Shih Tzu, as well as the French Bulldog.

  • Medium-Size Breeds

Dogs with this syndrome are far better represented among the smaller and larger breeds since only a few races can be put into the category of midsize dog range. They weigh between 20 and 50 pounds and they are the American Bulldog and the English Bulldog.

  • Large Breeds

Large breeds with this skull conformation include some of the biggest dogs on Earth – Mastiffs. These gigantic dogs (which can weigh up to impressive 200+ pounds) include Neapolitan Mastiff, the English Mastiff, as well as the bull mastiffs. The Boxers, on the other hand, are also brachycephalic, even though they’re not as large as the Mastiff as mentioned earlier. The same could be said about the extremely wrinkled Shar-Pei.

Mastiff running through the water

Causes of Brachycephaly

The pets with this syndrome have shortened facial bones, and these are caused by the specific abnormalities in the jaw structure. These defects are passed down from the parents to their puppies after two brachycephalic dogs mates. When you talk to the owners of short-nosed dogs, they will often say that this kind of a condition is entirely normal for their breeds, which is entirely correct – it’s even written in their breed standard.

However, these standards have been drawn up by people, as this is primarily a human-made condition that has been created by using selective breeding to achieve even flatter faces.

Brachycephalic jaw bones

The degree of brachycephaly that’s present in the affected breeds sports a vast range. To put it simply, the degree of brachycephaly is quite different when we compare breeds such as pug and the American Cocker Spaniel. The pug’s face is exceptionally flat, while the Spaniel has only a slight shortening of his muzzle.

The differences are also present in how this syndrome affects different kinds of the dog’s facial bones. Many breeds with this skull conformation, such as Pekingese and Pugs, have shortenings in both jaws. Bulldogs and Boxers, on the other hand, have lower jaws of standard length – only their upper jaws are shortened. This gives them a characteristic “jutting” lower jaw.

The brachycephaly is typically accompanied by some health issues that we will be analyzing later. The severity of these problems is, however, always related to the degree of the shortening of the dog’s skull.

Possible changes over time

There’s a tendency within each breed for the overall degree of this syndrome to become increasingly severe over time. Many brachycephalic breeds without muzzles can be seen having them in the old photographs, which is the definitive proof for this theory. The Bulldog, for example, is a breed that has become extremely brachycephalic over the last half of the century.

An extra worry is the fact that this syndrome has appeared in breeds that were never brachycephalic at all.

british bulldog skull
Image Source: Imgur.com

Different degrees of brachycephaly within a breed

Of course, the varying degrees of this condition are also currently present within each affected breed, especially in those races that sport more moderate degrees of the syndrome. Let us, for example, compare three imaginary Boxers and notice the different degrees between them:

  • The first one has wide open nostrils, which is a pretty good sign that he’s less likely to be affected by problems that are related to his skull’s shape. This would be a moderately brachycephalic dog, and this has been a feature of this breed for many generations.
  • The second pup has partly closed nostrils, as well as a slight nose roll that’s present below his eyes. If your boxer looks like that, he has a medium-degree of brachycephaly.
  • The third boxer’s nostrils are tightly pinched, and he has a pretty distinct nose roll that’s going over his nose’s bridge, between the eyes. This is an example of an extremely brachycephaly.

Problems for Flat-faced Dogs

Boxer pup

A muzzle of a healthy dog has a lot of tissue, and once his facial bones become shortened, this tissue won’t reduce along with the bone. This, in turn, causes folds on the skin, and these folds are capable of trapping things like bacteria and dirt.

This also causes problems on the inside – the tissue folds can severely compromise the pup’s airway. It’s the so-called Brachycephalic Airway Syndrome, which is one of the most common issues in dogs with this syndrome. Let’s have a closer look at it, and let’s also analyze the potential eye issues related to this condition.

Recommended Read: 10 Most Popular Hypoallergenic Dog Breeds

Brachycephalic Airway Syndrome

All dogs that suffer from this condition have at least a mild form of the Brachycephalic Airway Syndrome (BAS) – the more extreme cases might even require surgery. The symptoms of this airway obstruction would include things such as noisy breathing, snorting, snoring, as well as fainting during running or walking. Unfortunately, these conditions are prone to becoming worse over time, so it’s of crucial importance to closely monitor the pup and determine if he’s in need of surgery.

Let’s take a look at some BAS symptoms that could cause severe health issues:

  • Elongated soft palate

Almost every affected pooch has this – it covers his throat far more than it actually should. It can cause snoring and all sorts of difficulties in the hot weather.

  • Stenotic Nares

In other words, the stenotic nares are narrowed nostrils, and they lead to mouth breathing.

Shih Tzu
  • Tracheal Stenosis

It’s the narrowing of the trachea (wind-pipe) and something that makes panting extremely difficult for the dog.

  • Everted Laryngeal Saccules

The problematic breathing can easily inflame the dog’s saccules, obstructing the airway and requiring a surgical procedure.

  • Heat Stroke

Pets with BAS have difficulties in hot weather since they’re incapable of properly cooling down their own bodies. This can lead to a heat stroke, but more on that later.

Eye Problems

The brachycephalic dogs usually sport shallow eye sockets, and that’s something that causes an incorrect fit of the eyeballs in their heads. A simple blow to the back of the head could easily dislodge the pup’s eye – it will pop out of the socket and require immediate surgery to be repositioned.

Another thing that could cause the dislodging of the eyes is if the owner pulls the dog’s leash too strenuously. Because of this, and because of the fact that the rope is already having an adverse effect on your dog’s breathing anatomy, it is advised that such canines don’t wear collars but only harnesses while they’re being walked.


The eyes are also much more prone to all kinds of infections since their eyelids don’t function as well as on the dogs without this syndrome. As the eyelids are unable to completely close around the bulged eyeballs, the surface of the eyes will become dry and prone to things such as the eye ulcers. Additionally, the fur on the pup’s skin can rub the bulged eyes, which causes distress and pain to the animal. The bulged eyes can also disrupt the tear ducts and cause constant dripping that will stain the fur and make the pooch prone to additional infections.

Increased Risk of Skin Infections

Chronic skin infections and irritations are quite common with brachycephalic dogs, especially in extreme cases (with dogs that have excessive skin folds and wrinkles). These folds are typically located on the muzzle, but they can also be found at the vulva and around the tail in female dogs.

The deep skin folds cause retention of the moisture, which, in turn, leads to the development of yeast and bacteria. The skin secretions get trapped in the folds, thus creating a perfect environment for the bacteria that will feed on them. Unfortunately, bacteria will also produce some substances that will lead to irritation of the skin and all sorts of infections, creating even more problems for the affected pooch.

One of the first signs that indicate these types of problems is the unpleasant odor that comes from the folded skin of your brachycephalic pup. And since these folds can be pretty deep and thus hide the signs of infection, one has to inspect them more closely. Affected canines could also show signs of discomfort and pain, like quickly moving away once you touch the problematic areas. In such cases, it’s important to take the dog to vet for examination as soon as possible to avoid further complications.

Heatstroke in Flat-faced Dogs

Long noses of the dogs that are not affected by this syndrome are efficient radiators. Because canines don’t sweat through the skin like humans, they have developed a different method of losing heat. They do it by rapidly drawing air across the moist surfaces of the environment they’re currently in.

The primary reason why this “panting” is so practical is the fact that the surface area that’s inside the pup’s mouth is relative to his body’s size. This is precisely why the flat-faced dogs are unable to efficiently cool themselves – their muzzles are almost non-existing.

Lhasa Apso

The consequence of this is that these breeds can quickly overheat in hot weather. With their short noses, they’re simply unable to promptly lose the heat and regulate the body temperature, which can quite possibly lead to heatstroke. And as you already know, these things are hazardous – your flat-faced dog could easily die from one.

This is why it’s of crucial importance to prevent your pup from overheating or over-exercising. Try to keep the pooch inside during hot weather, and if you can’t, make sure to use things like bike baskets and strollers for transportation.

Dental Problems

Unfortunately, the flat-faced canines are also prone to dental problems. Dogs have 42 teeth which work well when they’re in proper order and position. Unfortunately, that’s not the case with flat-faced dogs – they still have 42 teeth, but they’re tightly crammed inside their tiny mouths.

The consequence of this is that the teeth are growing inward or are sticking out at odd angles. Food can easily get stuck between such teeth; leading to things like gum disease, infections, and even tooth loss if the condition is left untreated.

In canines, the deciduous teeth come out once they’re three weeks of age, while the permanent ones emerge once they’re three months old. The deciduous teeth are shed, thus leaving room for the permanent teeth to grow out. The things are, unfortunately, a bit different with the brachycephalic dogs – their deciduous teeth are cramped, remaining in place and preventing the permanent teeth from erupting.

French Bulldog playing with a ball

If your flat-faced dog’s deciduous teeth don’t emerge, the extra teeth will have to be removed (along with some permanent ones) allowing the remaining teeth to space out and have a proper fit inside the pup’s mouth. It’s up to the vet to determine which teeth need to be surgically removed.

What other Problems do Brachycephalic Dogs Have?

One of the most severe issues is that they’re at higher risk of experiencing negative effects while they’re under anesthesia. Since their airway is compressed, it can be tough for them to receive enough oxygen.

Their respiratory and heart rates are also quite unpredictable under anesthesia, especially in case of overweight canines. This is precisely why brachycephalic pups need smaller doses of anesthetic than the other breeds, and they also need to be very closely monitored during surgery. The animal needs to be carefully examined before undergoing anesthesia.

Another issue is the reverse sneezing, also known as MAR (Mechanosensitive Aspiration Reflex). As we already said, the flat-faced breeds have elongated soft palates, causing them to sometimes suck the palate into their throats and reverse-sneeze. Unlike the regular sneezing, the reverse sneezing is when the air is rapidly pulled inside the nose. If it becomes a chronic problem, it’s important to take the dog to the vet to avoid further complications and severe damage to the pup’s health.

We should also note that the flat-faced female dogs are very likely to encounter issues when giving birth, as the heads of their puppies are too big to go through the birth canal. Those having a pregnant brachycephalic dog should consider consulting with a vet and scheduling a C-section.

Helping Your Flat-faced Dog

If you’re an owner of a brachycephalic dog, you should know that there are some precautions you can take and thus reduce the risk of health problems for your four-legged friend. Here are some of them:

  • Like we already mentioned, avoid using a collar leash, and use a harness instead. Collars will give your pup a hard time with breathing and also put a strain on his eyes and the face.
  • Never let your canine companion over-exercise and overheat. Don’t let the dog go outside during excessively hot weather, and make sure to limit his exercise.
  • Make sure to keep the pup’s weight in a healthy range, since the obesity is inevitable to make his brachycephalic -related issues even worse.
  • Don’t forget to keep track of the dog’s snoring and snorting. Over time, you will learn the usual sounds of your pooch, and immediately notice new sounds, such as, for example, labored breathing or new snorting. And once you do, make sure to make an appointment with the local vet.
  • Together with a veterinarian, determine if a particular condition of your flat-faced friend requires a surgical procedure. Not all of these pups need surgery, but some will benefit from one (like palate shortening, for example).
  • Research has also now revealed that brachycephalic dogs are at the greatest risk when giving birth.


When humans started breeding more and more dogs with flat faces, they, unfortunately, never asked themselves whether such an action is dangerous for these dogs. Now, decades later, we can see that this crossbreeding wasn’t done in the best interests of these canines since they have to endure an abundance of various discomforts.

The degree of health issues with brachycephalic canines varies from one breed to another, as well as from one individual to another within a particular breed. Unfortunately, even the moderately affected pups usually have some health impairment, especially when we compare them to pups with normal facial bones. Those that plan to buy a flat-faced dog should be aware of the following problems that they might encounter:

  • Respiratory distress
  • Overheating
  • Dental problems
  • Infected skin folds

As you can see, these dogs paid a pretty hefty price for being cute; and the worst thing is that there are some additional health problems they could suffer from. Some of these issues are brain problems, joint defects, dwarfism, and many other complications. This is why we advise you to think before you buy – even though these are cute and fun-loving animals, be prepared to give them some extra care once they arrive at your home.

In this article, we’ve tried to cover everything that you should know about this syndrome, explaining its problems and showing you what steps to take in cases of certain conditions and complications. We hope we’ve been helpful, and we wish you great adventures with your beautiful flat-faced, four-legged friend!

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  1. I’ve been looking everywhere to find an experienced surgeon that uses a laser to shorten an elongated palate on my 5 yr. old Cane Corso in Upstate NY. I also would like it to be a 24/7 office because of complications that may occur, like the possibility of the throat swelling. Cornell Univ. has no one experienced in this surgery, although I’ve used them through the years for other surgeries.

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