\r\n\t* Swarm-based and market-based algorithms for controlling collectives of robots. \r\n\t* Control and task allocation with real restrictions like, for example, temporal constrains (deadlines) or communication restrictions. \r\n\t* Motion control algorithms, including formation and multi-robot obstacle avoidance. \r\n\t* New real applications of multi-robots systems to fill the gap between simulations and real robots.
",isbn:"978-1-83968-459-3",printIsbn:"978-1-83968-458-6",pdfIsbn:"978-1-83968-460-9",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,hash:"16b80587d8850186816a202aa630f76b",bookSignature:"Dr. José Guerrero and Dr. Oscar Valero",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10086.jpg",keywords:"real applications, temporal restrictions, communication restrictions, field robotics, bio-inspired approaches, swarm intelligence, auctions-based algorithms, optimization, agent-based systems, mathematics fundations, formation control, obstacle avoidance",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"December 2nd 2019",dateEndSecondStepPublish:"December 23rd 2019",dateEndThirdStepPublish:"February 21st 2020",dateEndFourthStepPublish:"May 11th 2020",dateEndFifthStepPublish:"July 10th 2020",remainingDaysToSecondStep:"9 days",secondStepPassed:!1,currentStepOfPublishingProcess:2,editedByType:null,kuFlag:!1,editors:[{id:"14262",title:"Dr.",name:"José",middleName:null,surname:"Guerrero",slug:"jose-guerrero",fullName:"José Guerrero",profilePictureURL:"https://mts.intechopen.com/storage/users/14262/images/system/14262.jpg",biography:'José Guerrero Sastre received a degree in Computer Science from the University of the Balearic Islands (UIB). In 2012, he completed his PhD in computer science at UIB with a thesis entitled "New Methodologies for allocating tasks and coalition formation in multi-robot systems". Since 2002 he is a member of the Department of Mathematics and Computer Science at the University of the Balearic Islands (UIB) , where he is currently a lecturer and postdoctoral researcher. He is also a member of the Systems, Robotics and Vision Group (SRV) since 2002, and since 2016 a collaborator of the Models for Information Processing (MOTIBO) research group. His research interests include multi-robot and multi-agent task allocation mechanisms with auction, swarm-like coordination mechanisms and possibility theory.',institutionString:"University of the Balearic Islands",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of the Balearic Islands",institutionURL:null,country:{name:"Spain"}}}],coeditorOne:{id:"116937",title:"Dr.",name:"Oscar",middleName:null,surname:"Valero",slug:"oscar-valero",fullName:"Oscar Valero",profilePictureURL:"https://mts.intechopen.com/storage/users/116937/images/system/116937.jpg",biography:"Oscar Valero Sierra received a BS degree and a Ms degree in Mathematics at the University of Valencia in 2000. Later on, in 2003, he received a Ph.D. in Mathematics at the Polytechnical University of Valencia. He was a visiting researcher at 'Center for Efficiency-Oriented Languages' which belongs to the Computer Science Department at National University of Ireland. He is currently an Associate Professor in the Department of Mathematics and Computer Science at Balearic Islands University. So far, he has taught lectures on bachelor's degrees in Engineering, Business Administration, Economics and Mathematics. His research activity focuses on Mathematical Models applied to Computer Science, Artificial Intelligence, Engineering and Economics.",institutionString:"University of the Balearic Islands",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of the Balearic Islands",institutionURL:null,country:{name:"Spain"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"22",title:"Robotics",slug:"physical-sciences-engineering-and-technology-robotics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"304289",firstName:"Rebekah",lastName:"Pribetic",middleName:null,title:"Ms.",imageUrl:"//cdnintech.com/web/frontend/www/assets/author.svg",email:"rebekah@intechopen.com",biography:null}},relatedBooks:[{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3794",title:"Swarm Intelligence",subtitle:"Focus on Ant and Particle Swarm Optimization",isOpenForSubmission:!1,hash:"5332a71035a274ecbf1c308df633a8ed",slug:"swarm_intelligence_focus_on_ant_and_particle_swarm_optimization",bookSignature:"Felix T.S. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"56361",title:"Conducting Polymers Films Deposited on Carbon Steel and Their Interaction with Crude Oil",doi:"10.5772/intechopen.70091",slug:"conducting-polymers-films-deposited-on-carbon-steel-and-their-interaction-with-crude-oil",body:'\n
\n
1. Introduction
\n
The formation of solid deposits is a frequent problem in the hydrocarbons transport due to asphaltenes precipitation where the crude oils flow. The asphaltenes are the fraction of higher molecular weight and polarity of the crude oil and they are responsible for these solid deposits, which usually give rise to several problems in the transport and processing of crude oil, mainly by the obstruction of the pipelines [1, 2, 3, 4, 5, 6].
\n
Common oilfield scales are crystalline deposits, resulting from the precipitation of mineral compound such as carbonates and sulfates present in the injected water, as method for enhanced oil recovery. These scale deposits may appear as a thick layer adhered to the inner walls of the pipes, they are often several centimeters thick with particles sizes up to 1 cm or more. One of the primary problems of scale formation in pipes is the reduction in flow rate by increasing the inner surface roughness of the pipe and reducing the flow ability area. This produces an increase in the pressure drop and consequently production decreases. By increasing the growth of deposited minerals, it becomes impossible to access deeper pipe sections, and finally the scale deposits end up blocking the flow of production. On the other hand, organic scales formation results from asphaltenes and waxes deposition. Usually, the localized corrosion can be developed beneath or around these deposits present in the steel surfaces, due to the presence of bacteria or sulfurous gas, which reduces the integrity of the metal.
\n
The petroleum in its natural state is a mixture of organic compounds of varied structures and different molecular weights. In general, it is possible to group the oil constituents into four well‐defined organic components: saturated, aromatic, resin, and asphaltenes [7], known as SARA. The study of the heavy oil fraction (asphaltenes) has increased in recent years due to the problems that they represent in the production and conversion processes. In general, the structure of asphaltenes is considered to consist of a condensed aromatic nucleus with side alkyl chains and heteroatoms incorporated into many of the cyclic structures. The condensed aromatic system may contain from 4 to 20 benzene rings [8]. Nowadays, there is a considerable debate about the structure of asphaltenes, particularly in the size of aromatic groups and how they are linked to other groups in the structure. The type and amount of deposits of heavy organic compounds varies depending on the hydrocarbons present, and the relative amount of each organic family involved. In general, asphaltenes deposition can be explained in detail on the basis of four effects or mechanisms: (1) effect of polydispersity, (2) colloidal steric effect, (3) aggregation effect, and (4) electrokinetic effect.
\n
On the other hand, during crude oil transportation through pipes, there may be sludge deposits along the line and these are also called sediments. The deposits at the bottom of the storage tanks or crude transport lines are water, salts, sand, and heavy hydrocarbons, and their average concentration is about 25% water, 5% inorganic compounds, and 70% vol. of hydrocarbons [9]. In general, asphaltenes deposits cause problems in five points: extraction, transportation, processing, economic benefit of crude oil, and environmental pollution. There are several methods to prevent and/or remove asphaltenes deposits: mechanical methods [10], chemical cleaning, pressure [11, 12], temperature and flow rate manipulations [13], additives, and chemical inhibitors [14, 15]. The conductive polymers applications are highly diverse and several studies have pointed out the different variables that affect the properties and performance of polypyrrole (PPy) electrodeposition on the steel surface such as the conductivity, stability, roughness, adhesion, film thickness, and so on [16, 17, 18, 19, 20, 21].
\n
When an electroactive conducting polymer coats a metal surface, it can act as a membrane‐like selective permeable layer, allowing the diffusion of certain ions and rejects others, depending on their chemical affinity, electronic structure, and inter‐ and intra‐molecular arrangement. In this context, some works have been reported on the inhibition of corrosion and stability of conductive polymer films on steel substrates [22, 23, 24].
\n
\n
1.1. Conductive polymers
\n
Conductive polymers are those synthetic polymers that are capable of conducting electrical current. These polymers may owe their conductivity to intrinsic properties of the material or modifications. Conductive polymers have a wide range of applications due to their physicochemical characteristics; many of these properties include electrical conductivity, electroactivity, electrochromism, environmental stability, chemical stability, among others [25, 26]. The scientific and technological development has given rise to two types of electronic conductive materials with polymer matrix: the intrinsically conductive polymers and the extrinsically conductive polymers [27].
\n
Several reviews in the literature focus on the corrosion protection by conductive polymers such as polyaniline (PANi), polypyrrole (PPy) and polythiophene (PTh). Although a number of possible protection mechanisms are proposed, the possible passivation of the metal by polymers such as polypyrrole or polyaniline is frequently indicated. In this work, we propose the use of PPy films to inhibit asphaltenes depositions. It is shown that the efficacy of conducting polymers for corrosion protection depends on the application modus and the experimental conditions, that is, depending on the suitable conditions, a conductive polymer may have excellent protection capacity or may lead to negative response of the coating. An important part of the deposition of PPy lies in the surface treatment of the electrode surface.
\n
Intrinsically conductive polymers are organic polymer in which the electrical conductivity originates from the extended electrons conjugation along the polymer chain. The most common conductive polymers (polyacetylene, polyparaphenylene, polypyrrole, polythiophene, and polyaniline) have carbon atoms in the backbone with sp2 hybridization. This hybridization creates covalent σ bonds between the carbons of the main chain and those of the branched chains. The sp2 hybridization leaves an unbonded orbital p (usually pz); these orbitals overlap and form a bond, with a distribution of C = C double bonds alternating with single carbon‐carbon bonds along the chain.
\n
Extrinsically conductive polymers are those that owe their conductivity to the inclusion of conductive materials such as metals, graphite, or charge transfer complexes in the polymer matrix, generally thermoplastic. In this case, above the percolation concentration, the conductive paths along the material give it electronic conductivity, while the polymer matrix allows the material to be processed in industrial operations to achieve different types of products and finishes [28]. The conductive polymers are formed from suitable monomers, and can be obtained either by chemical synthesis or by electrochemical methods (\nTable 1\n).
\n
\n
\n
\n
\n\n
\n
Conducting polymers
\n
General comments
\n
Refs
\n
\n\n\n
\n
Polypyrrole (PPy)
\n
PPy is chemically and thermally stable. The conductivity of PPy strongly depends on the preparation technique.
Thermally stable up to 500–600°C but is quite insoluble in most solvent, with potential applications as light‐emitting diode due to their electroluminescence properties.
Typical conducting polymers and their common applications.
\n
\n
\n
1.2. Electrochemical synthesis of conductive polymers
\n
The electrochemical synthesis of any conductive polymer has its particularities; however, there are a number of common factors in its synthesis that have been exposed and that must be taken into account at the time of its preparation. In principle, it is assumed that, except for the initiation step, the electrochemical polymerization will proceed by a similar mechanism as the thermal polymerization for the same monomer in a comparable environment.
\n
Experimentation usually begins with the evaluation of the potential window in the selected electrolyte medium, which will allow defining the electrochemical parameters for the subsequent electrolysis. In the evaluation stage as in the synthesis itself, strict control of electrochemical variables (electrode potential, electrode nature, current density, solution conductivity, electric field, etc.) and aspects such as medium, presence or not of protonating agents, oxygen, inert atmosphere, and so on [35] are observed.
\n
From a scientific point of view, the flow of an anodic current through an electrochemical system, formed by a monomer, a solvent, and an electrolyte, can initiate reactions such as the formation of an oxide layer on the electrode, oxidation of monomer on the metal, oxidation of the solvent, and oxidation of the electrolyte. But in this process, the polymerization develops an electrode coating the chemical nature of the electrode changes after a few seconds of polymerization from a metal electrode to a polymer electrode. So, the above reactions will occur at different potentials on the new electrode, and a new metal‐polymer interface appears in addition to that of the growth‐dissolution polymer and then new reactions will occur, oxidation of the polymer and degradation thereof [27].
\n
\n
\n
1.3. Applications of conducting polymers electrochemically synthesized
\n
Conductive polymers have been widely used in the fields of electrochemistry, electroanalysis, electrocatalysis, batteries and capacitors, and so on [36]. In these applications, the electrochemical activity and the conductivity are two important properties of the conducting polymers, because they play fundamental roles. In addition, small ions and molecules are able to diffuse into matrices of conducting polymers, providing other advantages over conventional electrode materials. This intrinsic property allows electrochemical reactions to take place along the matrices of the conducting polymers and thus increase the active sites for the electrochemical processes by using a 3D electrode. However, in order to efficiently utilize all active sites and improve mass transport during the electrode process, the film thickness of the conductive polymer should be reduced to facilitate diffusion of the ion in the polymeric matrix. Considering these factors, conductive polymer nanomaterials show different characteristics that can provide advantages over other materials. In addition, nanostructures can produce conductive polymers with new surface properties and new functions [36]. Different applications of conducting polymers prepared nanomaterials by electrochemical techniques as been reported: sensors [37, 38, 39], electrochemical capacitors [40], fuel cell electrodes [41], batteries [42, 43], electrochromic devices [44], and electrochemical actuators [45, 46, 47].
\n
\n
\n
1.4. Inhibitors of asphaltenes deposition by using conducting polymer coatings
\n
Polypyrrole (PPy) and polythiophene (PTh) are conductive polymers, which have been used as corrosion protection and have the characteristic that they can coat the steel [48, 49]. This process can be carried out by electropolymerization in aqueous phase; in addition, PPy exhibits good mechanical properties, thermal stability, and high conductivity [49]. The performance of corrosion protection by bi‐layered PPy coatings was investigated by Kowalski et al.; they used an inner PPy layer doped with molybdophosphate ions to protect steels from corrosion. The polymer layer maintained the passive state of the steel in an acid solution and a neutral NaCl solution for several days [22].
\n
Warren et al. [16] reported that anion dopants containing sulfonates, such as dodecylbenzenesulfonic acid (DBSA), can be used to form PPy films with high conductivities, good stability, mechanical properties, and apparent order. However, when there is a chemical‐physical mismatch at the metal‐polymer interface, the adhesion between the PPy layer and the metal substrate is generally poor [50].
\n
Beck and Michaelis [51] described anodic electrodeposition of black PPy films on steel electrodes from aqueous electrolytes containing the monomers and oxalic acid, with strong adherence and low surface roughness. Su and Iroh [52] investigated the electrodeposition mechanism of PPy coatings on steel substrates from aqueous oxalate solutions. Their results revealed the formation of a passive layer on the steel substrate before reaching the electropolymerization potential of pyrrole.
\n
Tüken et al. [53] prepared multilayer coating of polypyrrole/polyphenol on mild steel by cyclic voltammetry (CV). The corrosion performance of this multilayer coating was investigated by electrochemical impedance in sulfate solution. Another study carried out by the same authors consisted of the coating of copper with a mixture of polymers (PPy/PTh) [31]. They observed that the electrochemical synthesis of stable and homogeneous PTh films could not be achieved on copper electrode by direct oxidation of thiophene in acetonitrile‐LiClO4, due to insufficient surface passivation, and the copper dissolution in monomer oxidation potential region.
\n
On the other hand, Pekmez et al. [32] informed that the electrochemical synthesis of an anticorrosive polybithiophene (PBTh) on stainless steel is feasible, and the obtained PBTh coatings strongly adhered to the working substrate.
\n
Rocha et al. [14] carried out a study on the inhibition of asphaltenes precipitation in Brazilian crude oils using amphiphiles substances such as low molecular mass ethoxylated nonylphenols, vegetable oils (coconut essential oil, sweet almond, andiroba, and sandalwood oil), and organic acids (linoleic, caprylic, and palmytic). These compounds showed great efficiency in the asphaltenes precipitation inhibition, through a mechanism of asphaltenes stabilization as a function of its surfactant capacity.
\n
Castellano et al. [15] performed a theoretical investigation of σ‐π and π‐π interactions on benzene, pyridine, and thiophene dimers; they observed the influence of these interactions with asphaltene stability on crude oil and concluded that chemical interactions between species with opposite polarities lead to an intermolecular association in the asphaltenes, which are responsible for the phenomenon of aggregation. This study was aimed to understand why these compounds tend to aggregate and then flocculate in oil operation processes.
\n
The applications of the conducting polymers are highly diverse and rely on the final properties from the synthesis conditions [23, 24]. Therefore, conducting electrochemical studies to understand the effect of the synthesis variables that affect electrodeposition of conductive polymers is necessary, in order to attain the required conditions in each specific application, as it is the case for application in corrosion protection [54]. When the electroactive conducting polymer is coated to the electrode surface, it may work as a selective permeable layer, which allows certain ions and molecules to pass, according to the degree of cross‐linking of the films and supported molecules on the monomer. So the study of the surface properties of polymeric materials is justified, and the way in which the species present in the system can cause the material to deteriorate. In this context and considering the studies reported in the literature, the inhibitors of the asphaltenes deposit using PPy and PTh electrodeposited in carbon steel, is a novel application of this type of materials, in the literature there are few reports in this line of research.
\n
\n
\n
1.5. Interfacial interaction (contact angle)
\n
The deposition of a coating on a solid generates new interfaces between dissimilar materials and involves considerations of wettability, spreading, interface evolution, and adhesion. The interaction at solid‐liquid interface is determined by a balance between the adhesive and cohesive forces. Adhesive forces between a liquid and a solid cause a liquid drop to spread on the surface. The cohesive forces within the liquid cause the drop to maintain a stable position and avoid contact with the surface. This solid‐liquid interaction at the interphase is called wettability. The wettability of electrochemically deposited conductive polymer films depends to a large extent on several parameters, such as deposition conditions (applied voltage, transferred charge, etc.), dopant, and working electrode roughness [55]. Mecerreyes et al. [56] carried out a study where they obtained a hydrophobic PPy film (water contact angle of >90°) using a perfluorinated dopant anion, and a hydrophilic film using a ClO4\n− doping anion. Controlling the wettability of a solid surface is important in many applications, for example, in self‐cleaning surfaces, liquid lenses, smart fabrics, and in biomedicine [57, 58, 59].
\n
It has been reported that the roughness of hydrophobic solid increases its hydrophobicity due to two different ways: roughness increases the surface area of the solid, which geometrically enhances hydrophobicity and due to the air that can remain under the drop [60, 61]. It is important to note that a roughness at two or more length scales has been implicated as the cause of imitating the “lotus effect,” which is the characteristic of a lotus leaf to promote water repellency and self‐cleaning [62]. One method to surface wettability control is by oxidizing or reducing the polymer film by modifying thereby the surface morphology. Several research groups have produced films of superhydrophobic conductive polymers, creating micro‐ and nanostructured surfaces by tempering methods [63, 64, 65, 66]. However, these methods have a disadvantage due to the complexity of manufacturing processes [67].
\n
For both improved oil recovery and crude oil transport, it is necessary to develop chemical additives that modify the wetting behavior of reservoir rock (also known as a core), in order to facilitate the crude oil extraction, or to prevent it from wetting the pipe’s inner wall and allow crude oil to easily flow through pipelines [68]. The oilfield scale formations are associated to interface activity of polar components of the crude oil. Asphaltenes are the most polar fraction of the crude and contain large amounts of active species [69] and because of this, asphaltenes are reported as the major fractions responsible for altering surface wettability through the interaction of polar functional groups with polar sites of solid surface [70, 71]. A study by Kaminsky and Radke [72] indicates that low solubility asphaltenes can diffuse through water films to arrive at rock surfaces without significant wettability alteration; the rupture of the water film followed by direct deposition of crude oil onto rock allows explaining the wettability reservoir rock.
\n
\n
\n
\n
2. Experimental
\n
\n
2.1. Reagents and chemicals
\n
The electrolytes used were 0.1 M aqueous solutions of KNO3and KCl (both from J. T. Baker, reagent grade). Also a 0.1 M1 of pyrrole (Py, Sigma Aldrich) solution was prepared with previous purification in a bed column packed with silica and activated carbon. All the solutions were prepared with deoxygenated water (Millipore, 18.2 MΩ) for 15 min with an atmosphere of pure nitrogen (Praxair, 99.99%) before each experiment. The film stability was evaluated in a KCl electrolyte according to a procedure reported [73].
\n
The crude oil used in this work originates from the Gulf of Mexico and presents the following features: 15°API, 25% weight of asphaltenes, density 0.9647 g cm−3, and a kinematic viscosity of 1.697 mPa s.
\n
\n
\n
2.2. Materials
\n
A conventional three‐electrode cell was used for the electrodeposition of PPy over carbon steel (CS‐1018) as the working electrode, graphite electrode as counter‐electrode, and aqueous saturated calomel electrode, SCE (Tacussel), as reference electrode. Initially, the CS‐1018 electrode was polished with different grain sandpaper to achieve a defined surface and subjected to ultrasonic baths (Branson 2510) for 5 min to remove contaminants from the surface. To improve the adhesion of the polymer to the steel surface, it was necessary to carry out a pretreatment of the electrode with a mordant layer to increase the roughness. For this purpose, some authors [23, 24] immerse the metal electrode in acidic solutions of HCl or HNO3. In this work, the electrode was treated with acid solutions of 10% HNO3 with an immersion time of 2 min. The treated surfaces were designated as treated in HNO3(T) and only polished surfaces without acidic treatment were designated as untreated in HNO3(NT).
\n
\n
\n
2.3. Equipment
\n
The polypyrrole electrosynthesis was performed by cyclic voltammetry and chronoamperometry (CA) techniques by using a Gamry Reference‐600 potentiostat, in a three‐electrode cell at room temperature (20±3°C). The electrodeposition by cyclic voltammetry was carried out at a scan rate of 100 mVs−1, in a potential window of −0.8 to 1.0 V/SCE for 40 cycles of polymerization. The conditions for the chronoamperometry were at constant potential of 1.0 V/SCE, for 300 s. For the characterization of the polymeric films, a scanning electron microscope, SEM (Jeol, JSM-6390LV) coupled with energy dispersive spectroscopy (EDS) analysis (Oxford Instruments, INCAx-sight), an atomic force microscope, AFM (Veeco, Innova Scanning Probe Microscope), and an equipment to measure contact angle (Chem Instruments, CAM‐plus) were used. The contact angle measurements of polymer surfaces were conducted with deionized water and crude oil, analyzing two areas on the sample and considering three measurements in each zone taken every 2 min for 10 min.
\n
\n
\n
\n
3. Results and discussion
\n
\n
3.1. CS‐1018 electrode characterization
\n
The SEM and AFM micrographs of the CS‐1018 substrates are shown in \nFigure 1\n, where the lines attributed to the mechanical polishing are observed. The images show that the treated substrates, CS‐1018 T, present a rougher surface due to chemical attack with HNO3. The observed roughness measurements were of Rq = 0.0509 μm and Rq = 0.739 μm, for the untreated and treated surfaces, respectively. This difference in the roughness value will be important for the adhesion effect of the polymer material to be synthesized on it.
\n
Figure 1.
SEM and AFM micrographs of CS‐1018: (a) untreated (NT) and (b) treated (T) in 10% HNO3.
\n
\n
\n
3.2. PPy film electrodeposition
\n
In this work, the results obtained by two electrochemical techniques are presented: CV and CA. The electrodeposits were made in four different electrolytes, in order to find the best characteristics of the film. \nFigure 2a\n shows an example with the cyclic voltammograms of the polymerization of polypyrrole in electrolyte of KNO3. The voltammograms show the characteristic signals [74, 75, 76]. \nFigure 2b\n shows the signal of PPy deposited with applied constant potential method [77].
\n
Figure 2.
Electrochemical formation of PPy on CS‐1018 with (a) CV and (b) CA.
\n
\n
\n
3.3. PPy morphology on CS‐1018
\n
\n\nFigure 3\n shows the deposited PPy films on the CS‐1018 with and without treatment in the four different electrolytes, electrodeposited by CA technique. When KI and KF electrolytes were used, deposit films were not obtained, but when K2SO4 and KNO3 were used as electrolytes, the formation of PPy films was obtained.
\n
Figure 3.
PPy films electrodeposited on CS‐1018 substrates with and without treatment in four electrolyte media by CA technique.
\n
\n\nFigure 4a\n shows the SEM image of PPy deposited on CS‐1018 NT, in which a homogeneous film is observed that completely covers the surface of the steel. However, it is possible to observe lines in said film due to the polishing process of the steel, indicating that the deposited film is thin. By contrast, in the PPy film deposited on AC‐1018 T, non‐uniform circular agglomerates with needle‐shaped scales are observed, as can be seen in \nFigure 4b\n. This suggests that acid treatment to the steel affected the morphology of the deposited polymer. This observed morphologies show a characteristic topography of conductive polymers [78].
\n
Figure 4.
SEM and AFM micrographs of the PPy deposited by the chronoamperometry technique on untreated (NT) and treated (T) CS-1018 substrates: (a) in K2SO4 electrolyte untreated substrate, (b) K2SO4 electrolyte treated substrate, (c) KNO3 at 0.1 mol L-1 concentration on untreated and (d) treated substrates with 10% HNO3.
\n
\n
\n
3.4. Contact angle characterization of the PPy surface
\n
In order to analyze the surface of deposited PPy films, contact angle measurements were performed with and without water and crude oil on selected samples, and steel substrates with and without acid treatment. The measurements were performed in two areas of the sample and in each zone, three measurements were taken every 2 min. The contact angle values were obtained from the averages of the measurements. \nFigure 5\n shows the experimental setup, wherein a drop of water makes contact with the substrate CS‐1018 NT and how its image is projected to measure the contact angle.
\n
Figure 5.
Experimental setup for contact angle measurement.
\n
\n\nTable 2\n shows the values of the contact angle measurements with water and crude oil of the treated and untreated electrodes, and the respective formed polypyrrole films. It is noted that the contact angle of the CS‐1018 NT surface is about 70° with water and crude oil. In other words, the untreated metal surface has the same affinity for both liquids. When the steel surface is subjected to acid treatment, CS‐1018 T, the contact angle with water increases to 110°. This result indicates that nitric acid treatment induces a slightly hydrophobic behavior. On the other hand, the contact angle also increases slightly with crude oil and remains at a value close to 90°, that is, at the boundary between the oleophilic/oleophobic balances. Contact angle results show that the acid treatment to the metal surface provides hydrophobic properties to the surface; this measurement is in line with AFM results, showing greater surface roughness for electrodes exposed to acid medium. These results are consistent with those reported in the literature [52, 60, 74, 79].
\n
\n
\n
\n
\n\n
\n
Sample
\n
Contact angle/(°)
\n
\n
\n
Water
\n
Oil
\n
\n\n\n
\n
CS‐1018 NT
\n
70
\n
70
\n
\n
\n
CS‐1018 T
\n
110
\n
85
\n
\n
\n
PPy‐KNO3 on CS‐1018 NT by CV
\n
80
\n
83
\n
\n
\n
PPy‐KNO3 on CS‐1018 T by CV
\n
125
\n
90
\n
\n
\n
PPy‐K2SO4 on CS‐1018 NT by CA
\n
70
\n
70
\n
\n
\n
PPy‐K2SO4 on CS‐1018 T by CA
\n
90
\n
80
\n
\n\n
Table 2.
Contact angle values with water and oil of the electrodeposited polymers.
\n
According to this result, the polypyrrole films deposited on CS‐1018 T presented rougher surfaces than those synthesized on CS‐1018 NT. In both cases, after the synthesis and coating with PPy of the electrodes, the contact angle with water exhibited an increase as the surface roughness increases. PPy deposition on CS‐1018 NT has a slightly hydrophilic behavior contrary to the case when the polymer is synthesized on a treated surface.
\n
The contact angle values with crude follow the same trend as the water. This contact angle value is lower in the untreated surface, with apparently less roughness. However, these contact angle values in the presence of the polymer coating are close to 90°, the threshold value for determining the oleophilic nature of the electrode surface.
\n
Contact angle measurements show that the surface CS‐1018 T PPy‐KNO3 forms a contact angle greater than the surface of CS‐1018 NT PPy‐KNO3. That is, that the greater the porosity of the metal surface, a higher roughness of the polymer deposited is obtained, and consequently the polypyrrole‐oil interaction decreases.
\n
The roughness plays an important role for the hydrophobicity of the polymer deposit. According to the literature [80], hydrophobicity increases as the roughness of the material grows. \nFigure 6\n shows the average values of contact angle with oil as a function of roughness of the deposited polymer films. The materials with greater roughness presented greater contact angle than those with low roughness. It is observed that the contact angle of the PPy‐KNO3 with acid treatment by CV increased around 20° with respect to CS‐1018 NT. Therefore, this result shows that such polymer under certain conditions is efficient to reduce contact of asphaltenes with CS‐1018.
\n
Figure 6.
Relation between oil contact angle with the roughness of the polymer films.
\n
\n
\n
\n
4. Conclusions
\n
Acid pretreatment modifies the roughness of the CS‐1018 substrate generating an oxide layer that influences both the morphology and the stability of electrodeposited PPy films, creating surfaces with different arrangements, which depends on the electropolymerization technique employed. The roughness difference is directly related to the stability of the polymer film formed and its surface properties (wettability). CV electrodeposition is the most appropriate method for this type of application. The PPy materials deposited with KNO3 by CV, with and without treatment in an acid medium, presented a greater homogeneity and roughness. The roughness is directly proportional to the hydrophobicity of the PPy film, which was evidenced with an increase in contact angle values (lower affinity to crude oil). The inhibition of the asphaltene deposition is evidenced by obtaining contact angles of more than 90°. The results indicate that this methodology is cost‐effective, versatile, and scalable for the synthesis of electrodes for applications to inhibit asphaltenes deposition.
\n
\n
Acknowledgments
\n
O.E. Vázquez‐Noriega acknowledges the scholarship granted by CONACYT‐Mexico. We acknowledge the funding through CONACyT‐Mexico projects No. 177480 and the Fis. D. Pozas of the University of Colima for the study of SEM‐EDS microscopy. RD Martínez‐Orozco appreciates the postdoctoral scholarship by Fondo Sectorial‐CONACYT‐SENER grant No. 2138.
\n
\n',keywords:"conducting polymers, corrosion protections, carbon steel, polypyrrole, asphaltenes, crude oil",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/56361.pdf",chapterXML:"https://mts.intechopen.com/source/xml/56361.xml",downloadPdfUrl:"/chapter/pdf-download/56361",previewPdfUrl:"/chapter/pdf-preview/56361",totalDownloads:499,totalViews:319,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,dateSubmitted:"October 20th 2016",dateReviewed:"June 9th 2017",datePrePublished:"December 20th 2017",datePublished:"February 7th 2018",readingETA:"0",abstract:"The formation of scale/solids deposits inside the pipelines is a frequent problem in the petrochemical industry. These scales can be organic as the asphaltenes and inorganic as the accumulations of salts, which apart from blocking the inside of the pipes can also cause a change in the integrity of the steel. Therefore, it is necessary to avoid the conditions where deposition occurs, together with chemical and mechanical methods of remediation to mitigate the deposition. In this work we intend to use conductive polymers in order to inhibit the deposition of asphaltenes on carbon steel surfaces, by using polypyrrole (PPy) as material capable of conducting electrical current. The electrodeposition of PPy on carbon steel were performed by cyclic voltammetry (CV) and chronoamperometry (CA). The results showed that under certain experimental conditions it is possible to make a PPy film with adequate characteristics. Important factors were the grip and electrochemical stability of the formed film on steel, which depends on the electrosynthesis technique and in some cases favoured by a pre-treatment with a 10% HNO3 solution applied to the steel prior to electropolymerization. The PPy films deposited with pre-treatment completely covered the steel surface and showed better stability, adherence and generated a hydrophobic material.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/56361",risUrl:"/chapter/ris/56361",book:{slug:"recent-insights-in-petroleum-science-and-engineering"},signatures:"Oscar E. Vázquez‐Noriega, Javier Guzmán, Nohra V. Gallardo‐Rivas,\nReinaldo David Martínez Orozco, Ana M. Mendoza‐Martínez, María\nYolanda Chávez Cinco, Luciano Aguilera Vázquez and Ulises\nPáramo‐García",authors:[{id:"175028",title:"Dr.",name:"Ana María",middleName:null,surname:"Mendoza-Martínez",fullName:"Ana María Mendoza-Martínez",slug:"ana-maria-mendoza-martinez",email:"mendoza.martinez.ana@gmail.com",position:null,institution:null},{id:"186467",title:"MSc.",name:"Maria Yolanda",middleName:null,surname:"Chavez-Cinco",fullName:"Maria Yolanda Chavez-Cinco",slug:"maria-yolanda-chavez-cinco",email:"yolcin5@yahoo.com.mx",position:null,institution:null},{id:"186469",title:"Dr.",name:"Ulises",middleName:null,surname:"Paramo-Garcia",fullName:"Ulises Paramo-Garcia",slug:"ulises-paramo-garcia",email:"uparamo@itcm.edu.mx",position:null,institution:{name:"Instituto Tecnológico de Ciudad Madero",institutionURL:null,country:{name:"Mexico"}}},{id:"198863",title:"Dr.",name:"Nohra",middleName:"Violeta",surname:"Gallardo Rivas",fullName:"Nohra Gallardo Rivas",slug:"nohra-gallardo-rivas",email:"nohvigari@itcm.edu.mx",position:null,institution:{name:"Instituto Tecnológico de Ciudad Madero",institutionURL:null,country:{name:"Mexico"}}},{id:"198866",title:"MSc.",name:"Oscar E.",middleName:null,surname:"Vázquez-Noriega",fullName:"Oscar E. Vázquez-Noriega",slug:"oscar-e.-vazquez-noriega",email:"ose_vano@hotmail.com",position:null,institution:null},{id:"198868",title:"Dr.",name:"Javier",middleName:null,surname:"Guzmán-Pantoja",fullName:"Javier Guzmán-Pantoja",slug:"javier-guzman-pantoja",email:"jagupa@hotmail.com",position:null,institution:null},{id:"205433",title:"Dr.",name:"Reinaldo David",middleName:null,surname:"Martínez-Orozco",fullName:"Reinaldo David Martínez-Orozco",slug:"reinaldo-david-martinez-orozco",email:"rd.martinez.orozco@gmail.com",position:null,institution:null},{id:"205434",title:"Dr.",name:"Luciano",middleName:null,surname:"Aguilera-Vázquez",fullName:"Luciano Aguilera-Vázquez",slug:"luciano-aguilera-vazquez",email:"luciano.aguilera@gmail.com",position:null,institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_1_2",title:"1.1. Conductive polymers",level:"2"},{id:"sec_2_2",title:"1.2. Electrochemical synthesis of conductive polymers",level:"2"},{id:"sec_3_2",title:"1.3. Applications of conducting polymers electrochemically synthesized",level:"2"},{id:"sec_4_2",title:"1.4. Inhibitors of asphaltenes deposition by using conducting polymer coatings",level:"2"},{id:"sec_5_2",title:"1.5. Interfacial interaction (contact angle)",level:"2"},{id:"sec_7",title:"2. Experimental",level:"1"},{id:"sec_7_2",title:"2.1. Reagents and chemicals",level:"2"},{id:"sec_8_2",title:"2.2. Materials",level:"2"},{id:"sec_9_2",title:"2.3. Equipment",level:"2"},{id:"sec_11",title:"3. Results and discussion",level:"1"},{id:"sec_11_2",title:"3.1. CS‐1018 electrode characterization",level:"2"},{id:"sec_12_2",title:"3.2. PPy film electrodeposition",level:"2"},{id:"sec_13_2",title:"3.3. PPy morphology on CS‐1018",level:"2"},{id:"sec_14_2",title:"3.4. Contact angle characterization of the PPy surface",level:"2"},{id:"sec_16",title:"4. Conclusions",level:"1"},{id:"sec_17",title:"Acknowledgments",level:"1"}],chapterReferences:[{id:"B1",body:'\nMcSween HY, Richardson SM, Uhle ME. 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Effect of polar organic components on wettability as studied by adsorption and contact angles. Journal of Petroleum Science and Engineering. 1999;24:131‐144\n'},{id:"B72",body:'\nKaminsky R, Radke CJ. Asphaltenes, water films, and wettability reversal. Society of Petroleum Engineers Journal. 1997;2:485-493\n'},{id:"B73",body:'\nJohn R, Wallace GG. The use of microelectrodes to probe the electropolymerization mechanism of heterocyclic conducting polymers. Journal of Electroanalytical Chemistry and Interfacial Electrochemistry. 1991;306:157‐167\n'},{id:"B74",body:'\nWang Y, Northwood DO. An investigation into the nucleation and growth of an electropolymerized polypyrrole coating on a 316L stainless steel surface. Thin Solid Films. 2008;516:7427‐7432\n'},{id:"B75",body:'\nWang Y, Rajeshwar K. Electrocatalytic reduction of Cr(VI) by polypyrrole‐modified glassy carbon electrodes. Journal of Electroanalytical Chemistry. 1997;425:183‐189\n'},{id:"B76",body:'\nLehr IL, Saidman SB. Morphology and properties of polypyrrole electrosynthesized onto iron from a surfactant solution. Synthetic Metals. 2009;159:1522‐1528\n'},{id:"B77",body:'\nVázquez‐Noriega OE, Guzmán J, Gallardo‐Rivas NV, Reyes‐Gómez J, Mendoza‐Martínez AM, Rivera‐Armenta JL, Páramo‐García U. Polypyrrole films deposited on carbon‐steel CS‐1018 and its interaction with Mexican crude oil. International Journal of Electrochemical Science. 2015;10:6378‐6391\n'},{id:"B78",body:'\nAnsari Khalkhali R, Price WE, Wallace GG. Quartz crystal microbalance studies of the effect of solution temperature on the ion‐exchange properties of polypyrrole conducting electroactive polymers. Reactive and Functional Polymers. 2003;56:141‐146\n'},{id:"B79",body:'\ndos Santos RG, Mohamed RS, Bannwart AC, Loh W. Contact angle measurements and wetting behavior of inner surfaces of pipelines exposed to heavy crude oil and water. Journal of Petroleum Science and Engineering. 2006;51:9‐16\n'},{id:"B80",body:'\nGennes P‐Gd, Brochard‐Wyart FO, Quéré D. Capillarity and Wetting Phenomena: Drops, Bubbles, Pearls, Waves. New York, NY: Springer; 2004\n'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Oscar E. Vázquez‐Noriega",address:null,affiliation:'
Centro de Investigación en Petroquímica, División de Estudios de Posgrado e Investigación, Instituto Tecnológico de Cd. Madero, Prol. Bahía de Aldhair y Av. De las Bahías, Parque de la Pequeña y Mediana Industria, Altamira, Tamaulipas, Mexico
Instituto Mexicano del Petróleo, Eje Central Lázaro Cárdenas, Col. San Bartolo Atepehuacán, Mexico D.F., Mexico
'},{corresp:null,contributorFullName:"Nohra V. Gallardo‐Rivas",address:null,affiliation:'
Centro de Investigación en Petroquímica, División de Estudios de Posgrado e Investigación, Instituto Tecnológico de Cd. Madero, Prol. Bahía de Aldhair y Av. De las Bahías, Parque de la Pequeña y Mediana Industria, Altamira, Tamaulipas, Mexico
'},{corresp:null,contributorFullName:"Reinaldo David Martínez Orozco",address:null,affiliation:'
Centro de Investigación en Petroquímica, División de Estudios de Posgrado e Investigación, Instituto Tecnológico de Cd. Madero, Prol. Bahía de Aldhair y Av. De las Bahías, Parque de la Pequeña y Mediana Industria, Altamira, Tamaulipas, Mexico
'},{corresp:null,contributorFullName:"Ana M. Mendoza‐Martínez",address:null,affiliation:'
Centro de Investigación en Petroquímica, División de Estudios de Posgrado e Investigación, Instituto Tecnológico de Cd. Madero, Prol. Bahía de Aldhair y Av. De las Bahías, Parque de la Pequeña y Mediana Industria, Altamira, Tamaulipas, Mexico
Centro de Investigación en Petroquímica, División de Estudios de Posgrado e Investigación, Instituto Tecnológico de Cd. Madero, Prol. Bahía de Aldhair y Av. De las Bahías, Parque de la Pequeña y Mediana Industria, Altamira, Tamaulipas, Mexico
Centro de Investigación en Petroquímica, División de Estudios de Posgrado e Investigación, Instituto Tecnológico de Cd. Madero, Prol. Bahía de Aldhair y Av. De las Bahías, Parque de la Pequeña y Mediana Industria, Altamira, Tamaulipas, Mexico
Centro de Investigación en Petroquímica, División de Estudios de Posgrado e Investigación, Instituto Tecnológico de Cd. Madero, Prol. Bahía de Aldhair y Av. De las Bahías, Parque de la Pequeña y Mediana Industria, Altamira, Tamaulipas, Mexico
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1. Introduction
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For decades, the ability to reshape the human body was limited to dermolipectomy-based excisional procedures with long scars. Consumer demand for a minimally invasive alternative has been driven by interest in risk reduction, reduced scarring in the treatment region, and significant lessening of recovery time so that patients can return to work or regular activity within a short time span. Liposuction appeared to be the golden solution for many. While this minimally invasive procedure is a common approach, limitations can include residual skin laxity, an irregular skin contour, and little improvement in regions that were pendulous prior to the procedure. Subcutaneous tone is generally not improved with traditional suction-assisted lipectomy (SAL). Goals other than fat reduction include significant skin and soft tissue contraction in a smooth and even manner. While ultrasound and laser-assisted lipoplasty have been recommended for this purpose following liposuction, consistent outcomes have not been able to be achieved. The current literature suggests that radiofrequency (RF) energy is superior in achieving non-excisional soft tissue and skin shrinkage without surgical skin resection. By targeting the subcutaneous collagen matrix instead of just the skin, practitioners of body contouring are able to achieve up to 36% measured skin surface area contraction at 1 year following treatment with RF-assisted liposuction. While monopolar and bipolar radiofrequency-based devices for this purpose have been available for 10 years, only recently has a plasma-driven radiofrequency device been in introduced. The Renuvion device is FDA cleared for the purpose of soft tissue coagulation. The device is a modification of a standard Bovie electrocautery unit. The new configuration has a pressurized helium tank attached to the energy delivery system, so that helium plasma-driven energy is emitted from a hollow cannula when the device is activated. The handpiece is moved in the subdermal plane in a manner similar to that of a liposuction cannula. Emitted energy is fractional. Small fragments of stromal collagen are heated very quickly to 85°C, causing a reduction in fiber length of 40–50%.
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Because the measured skin temperature rarely exceeds 38°C, the safety profile of the device is optimized. Soft tissue treatment is usually performed following liposuction, but it can also be used in the subcutaneous plane without liposuction when skin contraction alone is desired. The use of the device for these purposes is considered off label.
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2. History of suction-assisted lipectomy (SAL)
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Patient and physician interest in limiting incisions and complications led to the development of liposuction in the late 1970s [1]. While Illouz [2] has commonly been given credit for coming up with liposuction as a new procedure, other surgeons before him used a combination of sharp cannulas without tumescent fluid to remove fat. German surgeons Schrudde, Meyer, and Kesselring performed liposuction in the early to the mid-1970s in such a manner [3]. Blood loss was significant, and clinical outcomes were not ideal.
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The Fischers, a father and son team, developed a blunt liposuction cannula in the mid-1970s [4].
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They treated only the thigh area. Frenchmen Illouz and Fournier spread the technique to other body regions and to other esthetic surgeons [5]. During the late 1970s, they began combining injection of intravenous fluid and hyaluronidase for the purpose of improving the ease of dissection. The term they used was “wet technique.” Klein [6] is credited with the concept of tumescent fluid, which differs from the French wet technique by adding both epinephrine (to reduce intraoperative blood loss) and lidocaine (for pain reduction during the procedure, so that it could be performed while the patient was awake). Sodium bicarbonate was added to the injectable fluid in order to reduce burning on injection when general anesthesia was not used. The safety of infusing large volumes of this solution was documented in studies performed by the dermatologic surgery contingent, who focused on lidocaine toxicity [7]. The complication rate with liposuction was significant though [8], and the ASAPS recommended limiting large volumes of infusion and lipoaspirate over 5 L to the hospital setting [9].
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Liposuction rapidly gained popularity but did not replace dermolipectomy, as limited skin surface area contraction was noted with SAL alone [10]. The development of energy-assisted liposuction was rapid and included ultrasound, laser, power, water-jet, shock wave, and radiofrequency-assisted liposuction [11, 12, 13, 14, 15, 16]. While many new devices have been utilized during the past 20 years, few have attained the simultaneous goal of significant and esthetically acceptable skin contraction in the treatment region.
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For decades, practitioners and patients alike have been focused on treating “skin laxity” without considering the true cause of the problem. Recent publications [17] show that the adipose/stromal framework of the skin may be a better treatment target. Rubin noted [18] that skin follows the substructure. If the scaffold or framework that the skin rests upon is weak or ptotic, the skin will follow, as it has no ability to hold a fixed shape on its own. If a practitioner chooses a device or treatment that does not target the framework, also known as the fibroseptal network (FSN), the goal of improving a pendulous structure will not be met without an excisional approach.
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How does the skin become lax? Facial aging studies show that the average person loses 235 cc of bony mass during a lifetime [19]. Certainly, there is associated muscle and fat atrophy with aging [20, 21]. While fat loss in the face and neck is a normal part of the aging process, these factors do not explain the loss of soft tissue tone. Serial scanning electron micrographs were taken from volunteers of various ages and similar skin types [22]. These show that with age, weight gain and loss, and genetic predilection, the stromal portion of the adipose framework for the overlying skin becomes weak, due to loss of the fibrocollagenous matrix and involution of the vascular network.
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While mechanical stimulation of the FSN with liposuction can create an 8% skin surface area contraction at 1 year posttreatment [23], the firm tone and defined shape of youthful body contours are not re-established. A thermal regenerative solution for this dilemma has been the focus of my energy-based device studies over the last decade.
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3. History of energy-based devices
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Ultrasound-assisted liposuction (UAL) was introduced by Zocchi in 1990 [24]. Reports of complications including seroma, burns, and contour irregularities caused a loss of popularity of this particular device. A current ultrasound-based device, Vaser, is still in regular use but is not targeted toward causing skin contraction. Power-assisted liposuction (PAL) is used by many practitioners who like the vibratory nature of the handpiece for treatment of fibrous areas and in secondary cases. Water-jet-assisted liposuction is excellent for fat grafting harvest, but does not improve the overall liposuction outcome. Laser-assisted liposuction (LAL) was shown to create a 13–17% skin surface area reduction at 3–6 months post-op [12]. Lack of a long-term outcome has led to a loss in popularity of this device. Radiofrequency-based tissue tightening has increased in popularity as longer-term improvement has been shown [23]. A bipolar device with indwelling liposuction capability was introduced in 2008 (Invasix) [16], and a monopolar device was cleared for soft tissue coagulation in 2012 (Thermi) [25]. This device utilized a subcutaneous cannula with an internal temperature probe. In 2012, a new version of the bipolar device (InMode) was introduced that contained both internal and external temperature monitors. A 50% improvement in upper arm pendulosity and a 36% skin surface area reduction at 1 year were seen with this device [26]. In 2016, the J-Plasma device (Bovie Medical) was introduced for the purpose of subdermal coagulation. The device was originally developed as a general surgical/gyn/urological laparoscopic cautery device. In esthetic cases, the cannula with blade retracted has been used in the subcutaneous plane for the purpose of collagen coagulation.
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4. Mechanical effects of liposuction
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Traditional SAL removes fat. However, the procedure is also a mechanical, nonthermal FSN stimulant. If simple fat reduction in a young patient with no soft tissue laxity is the goal, then fat removal and mechanical stimulation of the soft tissue will cause some reduction of the distended skin and soft tissue mass. Nonthermal trauma to the tissue induces an inflammatory response, which as we know causes inosculation of new blood vessels, generation of fibroblasts, and formation of new collagen or scar tissue within the treated space. Chemokines, cytokines, and growth factors all influence tissue response to mechanical injury [27]. Skin contraction with SAL measures about 10% at 6–8 weeks posttreatment [23] and then relaxes to a measured 8% skin surface area contraction at 1 year.
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Practitioners such as specialists like Gasparoni and Toledo used superficial liposuction to optimize skin shrinkage [28]. However, reports of complications resulting from treatment by other surgeons have diminished the popularity of this procedure [29]. Full-thickness skin loss due to aggressive superficial liposuction is still a concern, especially in Central and South America.
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5. Thermal effects of heating soft tissue
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When heat is added to mechanical stimulation, the soft tissue response changes. Thermal effects of radiofrequency energy can include ablation, coagulation, and collagen contraction [30]. While ablation without adjacent tissue damage is a desired goal in vaporizing tumors or lesions, the esthetic practitioner has more commonly used RF to cauterize blood vessels or to directly shrink soft tissue. Common use of a pencil-type cautery unit includes shrinkage of the SMAS in face lifting or a “popcorn” capsulorrhaphy in breast implant surgery.
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A newer concept is that of contraction of collagen fibers, a microeffect of RF energy on the tissue. Genin [31] notes that the native state of triple helical collagen strands change to a transitional state and then become denatured when temperature from the device over time causes the protein to unfold. In a study by Rossman [32], he showed that average collagen fibers measure 290 nm shrank to 101.5 nm when denatured, a contraction of 65%.
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The electric properties of tissue are governed by impedance or “resistivity” to energy conductance [33]. When a uniform tissue type is exposed to radiofrequency energy, impedance can be measured using a certain cross section with a measured distance between the electrodes [30]. Blood is highly conductive to RF energy with a slight lowering of impedance between 0 and 6 MHz. Its conductivity coefficient is 0.7 (low impedance), while fat has high impedance with a conductivity coefficient of 0.03. The value of adding tumescent fluid to fat is illustrated by contrasting the impedance of dry and wet skin. Dry skin conducts RF energy at a 0.03 coefficient—the same as fat, while wet skin has a 0.25 coefficient.
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If tissue is heating slightly—elevating the temperature from 37°C to 44°C, the metabolic process quickens [34]. At 45°C, there is a structural change in the collagen helix which leads to hyperthermic cell death. At 60–80°C, collagen proteins denature and unfold. At 90°C, tissues become dessicated, and at 100°C, they become thermally ablated.
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In treating patients, factors to consider include the “permittivity” of the tissue to heat, and the temperature achieved in the treatment region. These two factors, as well as duration of energy exposure, directly influence clinical outcome. The vascular perfusion to the area is another very important consideration. This can be compromised in patients who have had previous procedures in the treatment zone. The frequency and type of energy source will also affect tissue response.
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6. Radiofrequency energy in esthetic procedures
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Energy has been applied in some form to tissue since the beginning of recorded history. The practice of applying heat to tissue through the use of cauters was used for thousands of years as an invaluable method of controlling hemorrhage. Continuous improvement of methods for utilizing the beneficial effects of heat on tissue eventually led to the development of the basic concepts of electrosurgery we know today. In October of 1926, Dr. Harvey Cushing used an electrosurgical unit developed by Dr. William T. Bovie to successfully remove a highly vascularized brain tumor from a patient after previous failed attempts. Today, electrosurgical instruments are used in the majority of surgical procedures performed worldwide [35].
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Radiofrequency-based devices for skin rejuvenation became popular in the early 1990s, as a noninvasive device (Thermage) was used to improve tissue tone and texture. Other devices rapidly followed and utilized monopolar, bipolar, and multipolar configurations to treat the skin surface. While the Bovie cautery device has been used for decades in the subcutaneous plane, an open approach was needed. The first subdermal device to be used in a minimally invasive manner was the BodyTite device, which in 2008 had an accompanying liposuction cannula. The monopolar Thermi device utilizes a 10- or 15-cm slender monopolar cannula in a subdermal manner to heat soft tissue at the level of the fibroseptal network. These devices are characterized as “bulk heating” devices and create a radiant pattern of tissue heating from the probe tip outward.
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7. Characteristics of bulk heating devices
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Traditional subcutaneous monopolar and bipolar radiofrequency devices utilize a small cannula that is placed underneath the skin to heat the adipose tissue. They are called bulk heaters because the thermal energy generated from the tip of the device heats the adjacent tissue from the point of emanation. The surrounding tissue becomes warm gradually in a radiant distribution. Monopolar RF has only a single source of subcutaneous energy, and heat must accumulate in the tissue from this small point. A grounding pad is needed to safely treat the patient (Figure 1). Bipolar devices maintain a zone of energy between two sources, in this case, one internal and the other external (Figure 2). If the external treatment head is small, it will take a while for the tissue between the two emitters to heat up. Broader external heads create wider fields of heated tissue and are more time efficient. Energy output also influences the speed of tissue heating. Tumesced tissue increases the permittivity of the adipose layer toward heat. If liposuction is indicated, it should be performed prior to energy application. Then, tissue heating is optimized, as the heat-resistant adipose shield will have been removed from the collagen bands of the fibroseptal network, which have lower impedance. Advantages of these device types include ease of use, a known performance history, and many experienced users. Limitations include a long duration of heating if treatment areas are broad. Even with an external sensor such as a FLIR camera or external thermistor, burns and seromas can occur. Clinical endpoints of treatment include warmth, erythema, and a slight tissue reaction when the cannula is moved under the skin. While the internal cannula tip can get to the preset temperature quickly, the surrounding tissue takes time to get warm. Thus, there are “hot spots,” which may develop seromas, and areas where heating is not optimized. If the operator continues to heat a region that has already been optimally treated, cauterization of the microvasculature can cause ischemia, resulting in fibrosis or a burn. Knowing the amount of energy used is helpful, but a difficulty with any energy-based device is knowing when you are done. Factors that should reduce the amount of time and energy spent include an area with thin skin, a relatively thin layer of fat (such as the neck, face, and decollete), and any degree of existing fibrosis. FLIR studies show that when used in a primary case in the fibrous bra roll region, a bipolar device generated a skin temperature of 45°C for several minutes, even after the device was removed (Figure 3), despite the preset skin cutoff temperature being 38°C. A key to success when using these devices is to consider decreasing treatment time and measuring the skin temperature with FLIR in regions that have been previously treated and have some scar tissue and compromised blood supply. In fibrous areas, the physical nature of bulk heating can create a heat sink, due to the slow dispersion of heat. Compromised blood supply due to scarring or physical containment of heat is a region with fibrous fat which is a relative contraindication to the use of a subcutaneous bulk heating device.
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Figure 1.
Monopolar soft tissue coagulation device. The heated tissue radius is small, as the cannula tip is not large. There is a central region that heats to a high temperature, but this rapidly drops down at the periphery. A grounding pad is needed in order to safely treat the patient.
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Figure 2.
Bipolar configuration of a radiofrequency-assisted tissue tightening device. There is an internal and external heat sensor. The cannula is deployed in the subcutaneous fat in a manner similar to that of a liposuction cannula.
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Figure 3.
Illustration of methods used in tissue temperature study.
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8. Characteristics of the helium plasma-driven device
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Bovie Medical Corporation’s Renuvion® (formerly branded as J-Plasma®) helium-based plasma technology has FDA clearance for the cutting, coagulation, and ablation of soft tissue. The Renuvion® system consists of an electrosurgical generator unit, a handpiece, and a supply of helium gas. RF energy is delivered to the handpiece by the generator and used to energize an electrode. When helium gas is passed over the energized electrode, a helium plasma is generated which allows heat to be applied to the tissue in two different and distinct ways. First, heat is generated by the actual production of the plasma beam itself through the ionization and rapid neutralization of the helium atoms. Second, since plasmas are very good electrical conductors, a portion of the RF energy used to energize the electrode and generate the plasma passes from the electrode to the patient and heats tissue by passing current through the resistance of the tissue, a process known as Joule heating. These two sources of tissue heating give the Renuvion® device some unique advantages during use as a surgical tool for the coagulation of subcutaneous soft tissue for the purpose of soft tissue contraction.
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8.1. Renuvion® instant tissue heating versus bulk tissue heating
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Monopolar and bipolar RF devices available for subcutaneous soft tissue coagulation work on the principle of bulk tissue heating. The device is activated until a preset subcutaneous temperature in the range of 65–70°C is achieved and maintained. The tissue being treated must be maintained at that temperature for greater than 120 s for maximal contraction to occur. Although these devices have proven effective in achieving soft tissue contraction [36], the process of heating and maintaining that temperature for extended periods can be time-consuming. In devices without an external temperature monitor, the skin surface can become overheated, causing occasional blisters or burns.
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A study conducted on a live porcine model to establish the subdermal tissue temperatures produced by the Renuvion® device demonstrated a different philosophy for achieving soft tissue contraction when compared to the RF devices described above. See Figure 3 for an illustration of the methods used in this porcine study. The study simulated actual clinical conditions as closely as possible including tumescent infiltration and completion of liposuction on the abdomen of the pig. Prior to beginning treatment with the Renuvion® device, an incision was made through the epidermis and dermis into the subdermal plane to serve as a visualization window through which a forward-looking infrared radiometer (FLIR) camera could measure internal tissue temperatures. Multiple treatment passes of the Renuvion® device were then conducted using a matrix of various treatment combinations. For each treatment combination tested, a single treatment pass consisted of three strokes of the device in the subdermal plane (see Figure 3). The second treatment stroke was performed so that the tip of the Renuvion® device passed directly underneath the visualization window. This novel testing method allowed the FLIR camera to capture both internal and external tissue temperatures simultaneously. See Figure 4 for an example of the images captured by the FLIR camera as the device passes under the visualization window.
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Figure 4.
FLIR camera image.
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Typical results from the porcine study are shown in Figure 5. It is important to note that the time shown on the X-axis in this graph is reported in milliseconds.
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Figure 5.
Temperature vs. time (in ms) for Renuvion treatment [17].
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As shown in Figure 5, the Renuvion® device heats the tissue to temperatures greater than 85°C for between 0.040 and 0.080 s [17]. Heating the tissue to these temperatures for this period of time is adequate for achieving maximal soft tissue coagulation and contraction. However, unlike with bulk tissue heating, the tissue surrounding the treatment site remains at much cooler temperatures resulting in rapid cooling after the application of the energy through conductive heat transfer. Published studies have shown that the majority of soft tissue contraction induced by subcutaneous energy delivery devices is due to its effect on the fibroseptal network [12, 13]. Because of these unique heating and cooling properties of the Renuvion® technology, immediate soft tissue contraction can be achieved without unnecessarily heating the full thickness of the dermis. Practitioners who became used to the need for monitoring skin temperatures with a FLIR camera will find this is not needed with the Renuvion system.
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Figure 6 helps to visualize the differences between the bulk tissue heating of monopolar and bipolar RF devices and the instant tissue heating of the Renuvion® helium plasma device. The narrow difference between subdermal and epidermal temperatures of the monopolar and bipolar devices (top image in Figure 6) results in a delicate balance between achieving the subdermal temperatures needed for soft tissue contraction and maintaining safe epidermal temperatures, resulting in the need for constant internal and external temperature monitoring. A much larger difference between internal and external tissue temperatures for the Renuvion® device (bottom image in Figure 6) achieves maximal tissue contraction while maintaining safe skin temperatures without the need for temperature monitoring.
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Figure 6.
Differences in epidermal and subdermal temperatures for monopolar and bipolar RF devices (top) and Renuvion® helium plasma device (bottom). Author’s note: while a skin temperature of 45°C was noted in the porcine model, the maximum FLIR reading on a human subject’s epidermis has been 38°C.
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8.2. Renuvion®—360° tissue treatment
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It is known that electrical energy takes the path of least resistance. RF energy flows through the conductive plasma beam generated by the Renuvion® system. This conductive plasma beam can be thought of as a flexible wire or electrode that “connects” to the tissue that represents the path of least resistance for the flow of the RF energy. This tissue is typically either that which is in the closest proximity to the tip of the Renuvion® device or the tissue that has the lowest impedance (is the easiest to pass energy through). When used for the coagulation of subcutaneous soft tissue, this means that the energy from the Renuvion® device is not directed or focused in any set direction when activated in the subdermal plane. As the tip of the Renuvion® device is drawn through the subdermal plane, new structures are introduced to the tip of the device, and the path of least resistance is constantly changing. As the energy is constantly finding a new preferred path, the plasma beam quickly alternates direction, seeking out new structures to heat (see Figure 7). This allows for 360° tissue treatment without the need for the user to redirect the flow of energy. Since the collagen framework of the FSN is typically the closest tissue to the tip of the Renuvion® device, the vast majority of the energy delivered by the device results in coagulation and contraction of the fibroseptal bands. Maximizing the energy flow to the FSN expedites the soft tissue contraction process.
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Figure 7.
The Renuvion® plasma beam quickly alternates between treating the different tissues surrounding the tip of the device. Instead of treating all tissue in the field, the approach is fractional. By targeting low impedance targets, tissue shrinks well without excessive heating.
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8.3. Renuvion®—consistent power output
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The design of the electrosurgical generator for the Renuvion® plasma device is fundamentally different from that of monopolar and bipolar devices. As shown in Figure 8, monopolar and bipolar devices have limited power output in tissues with higher impedance, such as fat. The Renuvion® device was designed to maintain consistent power output over a wide range of impedances. When used for the coagulation of subdermal tissue, the Renuvion® output is not self-limiting and provides unencumbered delivery of power regardless of the tissue impedance.
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Figure 8.
Output power vs. impedance curves for subdermal energy devices.
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8.4. Renuvion®—minimal depth of thermal effect
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Not all RF energy is created equal. Experienced RF users know that you can achieve very different tissue results at the same power setting by simply changing from an RF waveform designed for cutting to an RF waveform designed for coagulation. The proprietary oscillating waveform of the Renuvion® device has much lower current than typical monopolar RF devices. In most cases, the current of the Renuvion® device is an order of magnitude lower. The current of the Renuvion® waveform flows through the conductive plasma beam to create additional beneficial Joule heating of the target tissue. However, since the current is so low, it is dispersed before it is able to penetrate deep into the tissue. This allows for soft tissue heating with minimal depth of thermal effect. This low current also prevents the tissue from being overtreated when subjected to multiple treatment passes. As the tissue is treated, it coagulates and desiccates resulting in an increase in tissue impedance. The lower current of the Renuvion® device is unable to push through higher impedance tissue. As the Renuvion® device passes in proximity to previously treated tissue, the energy will follow the path of least resistance (lower impedance) and preferentially treat previously untreated tissue. This prevents overtreating of any one particular area with multiple passes and maximizes the treatment of untreated tissue. Figure 8 shows a comparison of power versus impedance curves for bulk heating devices versus the plasma fractional RF device.
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8.5. Renuvion®—helium
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Although other inert gases can and have been used in plasma devices for medical applications, the Renuvion® device uses helium due to its unique properties which translate into certain clinical advantages. Helium has a simple molecular structure consisting of only two electrons. This simple structure allows helium to be ionized using very low input of energy. The ionization of helium is therefore very controlled and produces a precise and stable output of energy. Helium facilitates the use of the low-current, proprietary RF waveform from the Renuvion® generator.
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In summary, the Renuvion® helium-based plasma device from Bovie Medical has technological features that result in a unique and effective method of action for subdermal coagulation and contraction of soft tissue. These features are as follows:
The Renuvion® device achieves soft tissue coagulation and contraction by rapidly heating the treatment site to temperatures greater than 85°C for between 0.040 and 0.080 s [15].
The tissue surrounding the treatment site remains at much cooler temperatures resulting in rapid cooling after the application of the energy through conductive heat transfer.
Focused delivery of energy on immediate heating of the FSN resulting in immediate soft tissue contraction without unnecessarily heating the full thickness of the dermis.
360° tissue treatment without the need for the user to redirect the flow of energy due to electrical energy taking the path of least resistance.
Unencumbered delivery of power regardless of the tissue impedance due to the unique power output from the electrosurgical generator.
Low-current RF energy resulting in minimal depth of thermal effect and prevention of overtreating tissue when performing multiple passes.
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9. Indications
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Indications for treatment with plasma-driven RF include focal lipodystrophy with mild to moderate soft tissue laxity. Post-bariatric patients can be treated if the need for skin contraction is less than 33% and if pendulosity of the tissue is mild. If the patient’s focus is skin quality without excision, or improvement in poor soft tissue tone, the addition of this energy can improve outcomes. Patients who have given birth and want to restore their physique can also be helped, but diastasis recti can only be slightly improved with subcutaneous RF stimulation of the lax fascia. Breast lifting can be achieved to a significant degree, but the technique works best in patients with grade I and II ptosis and size C cup or less. The addition of a suspension suture can improve the outcome, especially for the subareolar and lower pole contour. Other popular treatment regions include the lower face and neck, upper arms, axilla, bra roll, abdomen and pubis, flanks, and circumferential thighs and knees.
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10. Contraindications
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Patients who should not be treated include:
Women who are pregnant or breastfeeding
Those with unrealistic expectations
Patients with an open sore in the treatment region
Patients with compromised healing such as oxygen dependence, diabetes if poorly controlled, and autoimmune disease
Severe pendulosity or skin/soft tissue laxity in the treatment region
Patients with significant skin compromise such as striae, scars, scleroderma, or lupus
Patients with previous treatments in the region of focus, thick or depressed scars, or poorly vascularized tissue
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11. Operative technique
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Patients are marked in an upright position. Depressions are marked, and protuberances are highlighted. The patient is asked to look down and note what she or he sees as the most important set of goals as far as fat reduction and skin tightening. This perspective may be somewhat different from the evaluating surgeon’s view.
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Steps in treatment include evaluation and marking, sterile prep and drape, and administration of anesthesia, which always includes tumescent infusion and can also include oral sedation, IV sedation, or general anesthesia. Liposuction, if indicated, of the treatment region is then performed. Treatment with subcutaneous heating of the Renuvion device follows. “Strokes” are considered as an insertion and slow withdrawal of the device. Ideally, the speed of withdrawal should be about 1.5 cm/s. A “pass” is considered to be a series of strokes performed from a single access point at the same depth. Lab studies show that in the typical treatment region, a series of three multidepth passes is required in order to see significant soft tissue and skin contraction within 24 h. In areas with a small surface area or limited amount of localized fat, two passes may be sufficient. Of course, in regions where adipose thickness is 3 cm or more, up to five passes at multiple depths may be needed in order to achieve the optimal outcome. Unless the treatment region is very thick, more than five passes in one region may be overtreatment.
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Clinical endpoints with the Renuvion device are different from those with bulk heating treatment. There will be little localized warmth or erythema, because it is not a bulk heating device. A visible contraction of the skin surface with the handpiece slightly angled up upon withdrawal is an indicator of good response. Because there is not an energy expended measurement on the current generator, a good indicator is activated time on the tissue. I usually treat a 10 × 15 cm segment of the tissue with 5 kJ, which correlates to 5 min of handpiece activation time per region.
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Some controversy exists regarding “cross-hatching” or creating a perpendicular series of passes in the same treatment zone. Because the device seeks out low impedance tissue to briefly heat, the “woven” or “crisscross” method is not routinely needed. However, in large areas or in regions needing optimal soft tissue contraction, this approach is recommended.
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Cross-hatching is contraindicated in areas such as the lower face, jowls, jawline, submentum, or decollete. Thin upper arm skin may also not need two perpendicular approaches.
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Treatment depths generally include the deep suprafascial zone, the midlevel of the adipose layer which corresponds to Scarpa’s fascia, and the immediate subdermal region. In patients with thin skin, striae, or a previous procedure in the treatment zone, a conservative two layer approach is recommended. In necks, a supraplatysmal and a subdermal approach are recommended.
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Multiple treatment levels are recommended to reduce the amount of adipose gliding that is seen with age, a decrease in the stromal collagen binding of fat, and hormonal change [37].
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Patients who note a disconnection of the soft tissue from the rectus fascia when leaning forward can gain some readherence with multilevel treatment. Suprafascial heating of the abdominal midline can decrease diastasis recti up to 1 cm. Further studies are needed to show the duration of this response.
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Enhancement of tissue response can be achieved by reducing local impedance with infusion of tumescent fluid and by removing the insulating adipose tissue. Undertumescing will decrease tissue response. An infusion ratio of 1:1 is recommended for most regions. By optimizing treatment temperature, the stromal fibrous collagen bands will contract more intensely and more quickly. A variety of optimal temperatures are shown in the biomechanical literature, ranging from 60 to 80°C. At lower temperatures, tissue contraction is slower. Perfusion is the most influential factor, as well as the most difficult to measure and influence. Good perfusion can be enhanced by avoiding overtumescing as the closing venous pressure will be exceeded. Using warm fluid is helpful. Vasodilators are not indicated. Perfusion can be compromised by mechanical factors such as tissue location in a fibrous area (flanks and bra roll). A frequently overlooked consideration is treatment in secondary cases. The presence of scar tissue in a patient who has undergone a previous procedure should be noted. The use of another energy-based device prior to the use of the primary heating device adds risk, such as liposuction using PAL or Vaser.
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It is important to consider the effect of adding pressurized gas when treating the secondary patient. Fibrosis, whether induced by previous minimally invasive procedures or by surgery, will change the direction of the gas, which will follow the path of least resistance. While not clinically dangerous, the creation of temporary subcutaneous crepitus can be disconcerting to the patient. Careful and thorough tunneling of the treatment region will allow for gas egress in these cases. The use of more than one access port is imperative. Tunnels should be created in such a way that they communicate with one another, and aspiration of gas at the end of the procedure will improve patient comfort.
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12. Results
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Significant improvement in the contour and pendulosity of skin and soft tissue has been seen with the combination of liposuction and helium plasma-driven radiofrequency energy.
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Interestingly, clinical endpoints are different with this device compared with bulk heaters. Because the skin does not heat up in broad regions, neither erythema nor warmth at the treatment site is an indicator of a completed treatment. However, early improvement can be seen as early as the next day.
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While the presence of some fat in the neck to be treated with bulk heating devices is desired, it is not necessary when using the Renuvion device. Figure 9 shows a 49-year-old woman with no fat in her neck preoperatively. A nice correction of her skin laxity is seen at 2 months post-op.
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Figure 9.
(a) A 49-year-old patient with neck laxity and (b) a patient 2 months following tumescent infusion and subcutaneous heating with Renuvion. No liposuction was performed.
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Figure 10 shows a 37-year-old man with gynecomastia and abdominal lipodystrophy. The device is quite good for treating larger surface areas on men or women, as the rapid heating of soft tissue has been shown to decrease overall operative time. Good definition without contour irregularities is noted postoperatively.
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Figure 10.
(a) A 37-year-old man with lipodystrophy of the abdomen, flanks, and chest and (b) a patient 3 months post treatment with liposuction and Renuvion soft tissue heating.
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The use of energy-based devices has been somewhat limited in the older patient. Because both skin quality and cohesiveness of the subcutaneous tissue can be compromised, these patients are usually offered excisional procedures. Figure 11 shows a 65-year-old woman who underwent circumferential liposuction and Renuvion RF tightening. She has excellent reduction of the skin envelope with improvement of skin tone and texture.
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Figure 11.
A 65-year-old woman with pendulosity of the volar upper arm (above). Below, a patient 3 months after circumferential liposuction and treatment with Renuvion. Pendulosity measurement decreased by 40%.
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Figure 12 shows a 37-year-old man who had multiple areas of lipodystrophy, despite an active job. He was treated with liposuction and helium-driven plasma RF tightening of the fibroseptal network in the chest, abdomen, and flank region. New technology shows the directional lift achieved in the lower abdomen that corrects the preoperative pendulosity. Skin compression diagram shows relative tightening of the skin in the treatment region (Figure 13).
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Figure 12.
This 38-year-old man had gynecomastia, abdominal lipodystrophy with pendulosity, and flank and waist fatty hyperplasia and tissue contraction at 6 weeks. (a) A patient before treatment and (b) a patient 6 weeks after liposuction plus Renuvion.
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Figure 13.
(a) Postoperative analysis of directional lift following liposuction and Renuvion RF assisted tissue tightening. (b) Compressive tissue analysis of the same patient following treatment with abdominal liposuction and Renuvion tissue tightening.
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13. Risk reduction in energy-assisted lipocontouring
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Side effects can be seen when using any energy-based device. With radiofrequency, most of these are thermal. There is a difference between expected sequelae and adverse sequelae.
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Expected sequelae include erythema, swelling, and redness and small scar at the access port sites. Bruising may be prolonged, and a temporarily modest improvement due to post-op swelling is expected. Patients may note they cannot fit into their regular size of clothing for a few weeks. Less than hoped for improvement in the early weeks is expected. Tissue contraction really becomes noticeable about 3 months post-op and continues for a year or more. Pre-existing asymmetry will not be totally corrected. Crepitus or air in the tissue due to residual helium is common, even if gas is expressed or suctioned at case end.
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Adverse sequelae can include persistent tissue pendulosity if present preoperatively. Creases or folds in the skin can occur if the patient is not careful about compression garment application. Small burns or blistering can occur but this is rare. If heat or ice is applied to the treatment region postoperatively, an area of full-thickness skin loss can occur. Unsatisfactory scarring at the access port sites may occur. Rarely, fibrosis can occur in overtreated regions. Undertreatment may result in residual lipodystrophy, a hooded umbilicus, or focal skin contour irregularities.
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These irregularities can also occur if fat pad thickness is not checked for uniformity prior to closure. Overly aggressive liposuction, especially if superficial, can leave an unattractive skin surface.
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Top 10 technical tips for achieving good outcomes:
Use DocMatter. The device company has set up a discussion forum, DocMatter. This website is easily accessible and promotes an open review of techniques and outcomes.
Initial assessment is critical. If the patient has a significant diastasis recti or needs more than 33% skin contraction, especially in a localized area, the treating physician should explain the limitations of a minimally invasive approach.
Treatment of multiple tissue layers is important. Dr. Sonja Sattler notes that the soft tissue regions have a gliding aspect in which the skin and superficial fat become disconnected with the deep fascia with aging. When performing abdominoplasty, I have noted that many patients have very little attachment of the deep fat to rectus fascia. Therefore, in order to reconnect the soft tissue to underlying fascia, it is optimal to treat several levels—suprafascial, midlevel, or Scarpa’s fascia and the immediate subdermal fat—with the Renuvion device. Clinical laboratory studies show that 3–4 passes (several ray-type strokes in a given region) will give optimal soft tissue and skin shrinkage in the average treatment region.
In regions with less fat, such as the neck, decollete, some arms, knees, and lower faces, only two levels of treatment are needed. Less is more here.
Because the current iteration of Renuvion does not measure energy expended, it can be difficult to understand the clinical endpoint. Clinical lab studies have shown that 1 min of activated handpiece time on the tissue is equivalent to 1 kJ of energy. If a 10 × 15 cm region is demarcated, an average of 5 min time on the tissue is optimal. This is equivalent to about a hand-sized region.
In regions where the skin is thin, less energy is needed. In the neck and jawline, 3–5 kJ total is recommended. A region of risk is the central cervicomental angle. By marking this area, and avoiding repeated passes, the risk of a burn is diminished.
Compression is king. Patients are informed that the best outcomes are obtained when a team approach is adopted. The surgeon can only influence the outcome during the surgical procedure and in the office during postoperative visits. It is the patient’s responsibility to perform proper aftercare. By utilizing serially smaller compression garments and kinesiology tape where indicated, the desired smooth contour can be optimized.
Dr. Adam Rubenstein notes that patient selection is the most important aspect of treatment. Choosing a patient with a mild to moderate amount of subcutaneous fat and associated skin laxity is key. Managing expectations should be done at the outset in order to avoid postoperative disappointment. By reminding the patient that minimally invasive procedures cannot achieve the degree of change seen with skin excision, patient understanding of expected outcomes is optimized.
Dr. Ed Zimmerman recommends venting the access port not in use with a 1 cc syringe and plunger removed. This saves time as little gas is retained.
Dr. Gerhard Sattler likes to use a bit more tumescent fluid in a secondary treatment, as well as the PAL handpiece. This approach optimizes tunneling though fibrous tissue and allows for more thorough liposuction, tissue protection from overtreatment, and creation of regions of low impedance recipient tissue.
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14. Conclusion
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The use of helium-driven plasma energy is a new and promising resource for achieving non-excisional soft tissue and skin tightening. The use of the device for skin tightening is off label. This versatile treatment can be used in multiple regions, and its safety profile is strong. Because the subcutaneous fibroseptal network is the treatment target, there is no real focus on heating overlying skin. Clinical FLIR measurements show that in an average treatment region, skin temperatures get to about 38° when treated with Renuvion, as opposed to 45° and higher with bulk heating devices. Because the device rapidly heats a small segment of subcutaneous collagen to 85°C, strong immediate contraction is generated within 0.044 s. A rapid post-liposuction tissue treatment is followed by very visible improvement at the 24 h post-op mark. Results can continue to improve over a year, as infiltration of new collagen within the adipose stroma occurs. Restoration of the adipose framework can recreate a firm rather than flabby feel of the soft tissue, along with a defined shape.
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\n\n',keywords:"skin tightening, radiofrequency, impedance based, minimally invasive, helium plasma",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/66073.pdf",chapterXML:"https://mts.intechopen.com/source/xml/66073.xml",downloadPdfUrl:"/chapter/pdf-download/66073",previewPdfUrl:"/chapter/pdf-preview/66073",totalDownloads:479,totalViews:4,totalCrossrefCites:0,dateSubmitted:"October 5th 2018",dateReviewed:"January 7th 2019",datePrePublished:"March 8th 2019",datePublished:null,readingETA:"0",abstract:"Consumer demand for a minimally invasive alternative to dermolipectomy-based excisional procedures has been driven by interest in risk reduction, reduced scarring in the treatment region, and significant lessening of recovery time. While minimally invasive liposuction is a common approach, limitations can include residual skin laxity and irregular skin contour. The current literature suggests that radio frequency energy is superior in achieving non-excisional soft tissue and skin shrinkage without surgical skin resection. Monopolar and bipolar radiofrequency-based devices have been available for 10 years. Recently, a plasma-driven radiofrequency device, Renuvion, was introduced and FDA cleared for soft tissue coagulation. The device uses a pressurized helium tank to drive radiofrequency energy into a hollow cannula. As measured skin temperature rarely exceeds 38?C, the safety profile of the device is optimized. The use of helium-driven plasma energy is a new and promising resource for achieving non-excisional soft tissue and skin tightening. Because the device rapidly heats subcutaneous collagen, strong immediate contraction is generated within fractions of a second. This treatment is followed by very visible improvement at the 24 hour post-op mark. Results can continue to improve over a year, as infiltration of new collagen within the adipose stroma occurs.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/66073",risUrl:"/chapter/ris/66073",signatures:"Diane Irvine Duncan",book:{id:"7836",title:"The Art of Body Contouring",subtitle:null,fullTitle:"The Art of Body Contouring",slug:"the-art-of-body-contouring",publishedDate:"August 28th 2019",bookSignature:"Alexandro Aguilera",coverURL:"https://cdn.intechopen.com/books/images_new/7836.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"162339",title:"Dr.",name:"Alexandro",middleName:null,surname:"Aguilera Salgado",slug:"alexandro-aguilera-salgado",fullName:"Alexandro Aguilera Salgado"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. History of suction-assisted lipectomy (SAL)",level:"1"},{id:"sec_3",title:"3. History of energy-based devices",level:"1"},{id:"sec_4",title:"4. Mechanical effects of liposuction",level:"1"},{id:"sec_5",title:"5. Thermal effects of heating soft tissue",level:"1"},{id:"sec_6",title:"6. Radiofrequency energy in esthetic procedures",level:"1"},{id:"sec_7",title:"7. Characteristics of bulk heating devices",level:"1"},{id:"sec_8",title:"8. Characteristics of the helium plasma-driven device",level:"1"},{id:"sec_8_2",title:"8.1. Renuvion® instant tissue heating versus bulk tissue heating",level:"2"},{id:"sec_9_2",title:"8.2. Renuvion®—360° tissue treatment",level:"2"},{id:"sec_10_2",title:"8.3. Renuvion®—consistent power output",level:"2"},{id:"sec_11_2",title:"8.4. Renuvion®—minimal depth of thermal effect",level:"2"},{id:"sec_12_2",title:"8.5. Renuvion®—helium",level:"2"},{id:"sec_14",title:"9. Indications",level:"1"},{id:"sec_15",title:"10. Contraindications",level:"1"},{id:"sec_16",title:"11. Operative technique",level:"1"},{id:"sec_17",title:"12. Results",level:"1"},{id:"sec_18",title:"13. Risk reduction in energy-assisted lipocontouring",level:"1"},{id:"sec_19",title:"14. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'Bellini E, Grieco MP, Raposio E. A journey through liposuction and liposculture: Review. Annals of Medicine and Surgery. 2017;24:53-60. DOI: 10.1016/j.amsu.2017.10.024\n'},{id:"B2",body:'Illouz Y. Body contouring by lipolysis: A 5 year experience with over 3000 cases. Plastic and Reconstructive Surgery. 1983;72:511\n'},{id:"B3",body:'Kesselring LK, Meyer R. A suction curette for removal of excessive local deposits of subcutaneous fat. Plastic and Reconstructive Surgery. 1978;62:305\n'},{id:"B4",body:'Fischer A, Fischer G. First surgical treatment for molding body\'s cellulite with three 5 mm incisions. Bulletin of the International Academy of Cosmetic Surgery. 1976;3:35\n'},{id:"B5",body:'Illouz YG. History and current concepts of lipoplasty. Clinics in Plastic Surgery. 1996;23:721-730\n'},{id:"B6",body:'Klein JA. Tumescent technique for local anesthesia. The Western Journal of Medicine. 1996;164(6):517\n'},{id:"B7",body:'Klein JA, Jeske DR. Estimated maximal safe dosages of tumescent lidocaine. Anesthesia and Analgesia. 2016;122(5):1350-1359\n'},{id:"B8",body:'Sattler G, Eichner S. Complications of liposuction. Der Hautarzt. 2013;64(3):171-179. DOI: 10.1007/s00105-012-2487-8\n'},{id:"B9",body:'Iverson RE, Lynch DJ. American Society of Plastic Surgeons Committee on Patient Safety. Practice advisory on liposuction. Plastic and Reconstructive Surgery. 2004;113(5):1478-1490, discussion 1491-5\n'},{id:"B10",body:'Sumrall AJ. A review of liposuction as a cosmetic surgical procedure. Journal of the National Medical Association. 1987;79:1275-1279\n'},{id:"B11",body:'Maxwell GP, Gingrass MK. Ultrasound-assisted lipoplasty: A clinical study of 250 consecutive patients. Plastic and Reconstructive Surgery. 1998;101:189-202, discussion 203\n'},{id:"B12",body:'DiBernardo BE, Reyes J. Evaluation of skin tightening after laser-assisted liposuction. Aesthetic Surgery Journal. 2009;29:400-407\n'},{id:"B13",body:'Fodor PB. Power-assisted lipoplasty versus traditional suction-assisted lipoplasty: Comparative evaluation and analysis of output. Aesthetic Plastic Surgery. 2005;29(2):127\n'},{id:"B14",body:'Man D, Meyer H. Water jet-assisted lipoplasty. Aesthetic Surgery Journal. 2007;27:342-346\n'},{id:"B15",body:'Kiełczewska M, Szymczyk J, Leszczyńsk R, Błaszczyk. The effect of high-frequency current and ultrasonic wave on selected indicators of body weight. Polski Merkuriusz Lekarski. 2015;38(225):150-154\n'},{id:"B16",body:'Blugerman G, Schavelzon D, Paul MD. A safety and feasibility study of a novel radiofrequency-assisted liposuction technique. Plastic and Reconstructive Surgery. 2010;125:998-1006\n'},{id:"B17",body:'Paul M, Mulholland RS. A new approach for adipose tissue treatment and body contouring using radiofrequency-assisted liposuction. Aesthetic Plastic Surgery. 2009;33:687-694\n'},{id:"B18",body:'Rubin JP, Khachi G. Mastopexy after massive weight loss: Dermal suspension and selective auto-augmentation. Clinics in Plastic Surgery. 2008;35(1):123-129. Review\n'},{id:"B19",body:'Cotofana S, Fratila AA, Schenck TL, Redka-Swoboda W, Zilinsky I, Pavicic T. The anatomy of the aging face: A review. Facial Plastic Surgery. 2016;32(3):253-260. DOI: 10.1055/s-0036-1582234. Epub 2016 Jun 1\n'},{id:"B20",body:'Watanabe M, Buch K, Fujita A, Christiansen CL, Jara H, Sakai O. MR relaxometry for the facial ageing assessment: The preliminary study of the age dependency in the MR relaxometry parameters within the facial soft tissue. Dento Maxillo Facial Radiology. 2015;44(7):20150047. DOI: 10.1259/dmfr.20150047\n'},{id:"B21",body:'Szczerkowska-Dobosz A, Olszewska B, Lemańska M, Purzycka-Bohdan D, Nowicki R. Acquired facial lipoatrophy: Pathogenesis and therapeutic options. Postepy Dermatologii i Alergologii. 2015;32(2):127-133\n'},{id:"B22",body:'Duncan DI. Aging Adipose Tissue in Skin Types I-VI: Scanning Electron Micrograph Analysis. Paris, France: IMCAS Paris; 2015\n'},{id:"B23",body:'Duncan Duncan DI. Nonexcisional tissue tightening: Creating skin surface area reduction during abdominal liposuction by adding radiofrequency heating. Aesthetic Surgery Journal. 2013;33(8):1154-1166\n'},{id:"B24",body:'Zocchi M. Ultrasonic liposculpturing. Aesthetic Plastic Surgery. 1992;16:287-298\n'},{id:"B25",body:'Key DJ. A preliminary study of a transdermal radiofrequency device for body slimming. Journal of Drugs in Dermatology. 2015;14(11):1272-1278\n'},{id:"B26",body:'Duncan DI. Improving outcomes in upper arm liposuction: Adding radiofrequency-assisted liposuction to induce skin contraction. Aesthetic Surgery Journal. 2012;32(1):84-95\n'},{id:"B27",body:'Landen N, Li D, Stahle M. Transition from inflammation to proliferation: A critical step during wound healing. Cellular and Molecular Life Sciences. 2016;73(20):3861-3885\n'},{id:"B28",body:'Toledo LS. Syringe liposculpture. Clinics in Plastic Surgery. 1996;23:683-693\n'},{id:"B29",body:'Hughes CE 3rd. Reduction of lipoplasty risks and mortality: An ASAPS survey. Aesthetic Surgery Journal. 2001;21:120-127\n'},{id:"B30",body:'Duncan DI, Kreindel M. Basic radiofrequency: Physics and safety and application to aesthetic medicine. In: Lapidoth M, Halachmi S, editors. Radiofrequency in Cosmetic Dermatology, Aesthet Dermatol. Vol. 2. Basel: Karger; 2015. pp. 1-22\n'},{id:"B31",body:'Huang G, Li F, Zhao X, Ma Y, Li Y, Lin M, et al. Genin functional and biomimetic materials for engineering of the three-dimensional cell microenvironment. Chemical Reviews. 2017;117(20):12764-12850. DOI: 10.1021/acs.chemrev.7b00094\n'},{id:"B32",body:'Arunachalam SP, Rossman PJ, Arani A, Lake DS, Glaser KJ, Trzasko JD, et al. Quantitative 3D magnetic resonance elastography: Comparison with dynamic mechanical analysis. Magnetic Resonance in Medicine. 2017;77(3):1184-1192. DOI: 10.1002/mrm.26207. Epub 2016 Mar 26\n'},{id:"B33",body:'Duck FA. Physical Properties of Tissue. London: Academic Press Limited; 1990\n'},{id:"B34",body:'Thomsen S. Pathologic analysis of photothermal and photomechanical effects of laser-tissue interactions. Photochemistry and Photobiology. 1991;53:825-835\n'},{id:"B35",body:'Massarweh NN, Cosgriff N, Slakey DP. Electrosurgery: History, principles, and current and future uses. Journal of the American College of Surgeons. 2006;202(3):520-530\n'},{id:"B36",body:'Hurwitz D, Smith D. Treatment of overweight patients by radiofrequency-assisted liposuction (RFAL) for aesthetic reshaping and skin tightening. Aesthetic Plastic Surgery. 2012;36(1):62-71\n'},{id:"B37",body:'Sattler G, Sommer B, Bergfeld D, Sattler S. Tumescent liposuction in Germany: History and new trends and techniques. Dermatologic Surgery. 1999;25(3):221-223\n'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Diane Irvine Duncan",address:"momsurg@aol.com",affiliation:'
Private Practice, Fort Collins, Colorado
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