Insomnia and Varicose Veins - The Alan Titchmarsh Show

10 January 2014

Dr Kremer speaks on The Alan Titchmarsh ShowBy Plastic Surgeon Dr Dirk Kremer

After a week away from The Alan Titchmarsh Show, I returned on the 6 th November where Dr Anita Sturnham, dietician Lucy Jones and I spoke about a range of medical problems including the issue of insomnia, varicose veins and even weak fingernails!


The first medical problem we spoke about was insomnia. This condition is common in adults and affects around 40% of adults in the UK. No one really understands why people suffer from Insomnia but there are few ways you can reduce your chances of developing it. The first is to try and make your bedroom as relaxing and as quiet as possible, you should remove TVs, radios, clocks and mobile phones so you’re not tempted to engage with them before sleep. You should also avoid working in the bedroom as that will prevent you from ‘shutting down’ and getting a good night’s sleep.

Another technique you can try is decorating your room in a darker more soothing colour as bright colours such as white, yellow or orange can reflect any light in the room, making it harder to settle down. If you do suffer from Insomnia try going to bed and waking up at the same time every day for two weeks as this may restart your sleeping pattern.

Lower blepharoplasty

Many people who suffer from insomnia develop ‘bags’ under their eyes that no amount dieting or lifestyle changes can fix. To remove them, you’ll need a plastic surgery procedure known as a lower blepharoplasty.

The ‘bags’ under eyes are made from orbital fat. As in the upper eyelid there is a septum running along the orbital rim which keeps the orbital fat within the bony orbit to protect the soft eyeball from hitting against the bony skull. This septum can be genetically very weak or it usually weakens with ageing as it bares the constant pressure of the fat and finally gives in. The fat can bulge outwards into the eyelid which we see as so-called 'eyebags'. The procedure involves making a small, barely visible cut below the eye lashes of the under lid. The skin of the lower eyelid is undermined, the ring muscle of the eye is spread and fat is then removed through stab incisions of the three compartments of the septum. For people who have extreme bags excessive skin may remain, the procedure also removes small strips of the eyelid in order to remove this skin.

A blepharoplasty is usually performed under local anaesthetic and the procedure typically takes 45-60 minutes. It is advised that you take about a week off work in order to fully recover from the procedure. Complications are rare but can include excessive pain, swelling or bleeding. It is imperative that you speak with your plastic surgeon should you develop any of these complications.

In people who have no excess skin the incision can be made in the mucosa of the lower eyelid. If this access is chosen no extra skin can be removed.

Varicose Veins

Varicose veins are swollen, enlarged veins which may also be bumpy or twisted. They are more common in older people but can affect people of all ages and health conditions.

Most people suffer no adverse effects when suffering from varicose veins, but there is a surgical procedure that can be performed to remove the veins. This is called a phlebectomy. This procedure removes the veins by creating multiple small incisions in the skin of about 2-3mm. A phlebectomy catheter is then inserted through the incision and pushed all along through the vein. At the end this catheter is clamped to the vein.

The procedure is extremely safe and complications are uncommon; as the procedure is completed under a local anaesthesia people are able to return to everyday life almost immediately. However it is recommended that patients rest for a least a day just as a precaution.

If you watched the show and are interested in any of the plastic surgery procedures mentioned, please get it touch with me to organise a consultation where we’ll talk about your situation and whether plastic surgery is the right option for you.


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