Evaluation of Efficacy and Safety of Alcarisa (Hyaluronic Acid Produced by Espad Pharmed Co.) for Restoration of Mid-face Volume

Inclusion Criteria: * Men and women aged 30 to 65 years * Individuals with moderate to significant mid-face volume loss (score 3 to 4) based on changes in MFVDS (in cases of asymmetry between the two sides of the face, the more severe side will be considered) * Ability to comply with visit schedules and study procedures * Signed the informed consent form and agreed to 6-month follow-up Exclusion Criteria: * History of Type I hypersensitivity reactions or anaphylaxis * Known allergy or sensitivity to any components of the filler, lidocaine, or to proteins from the HA-producing microorganisms (Streptococci) * History of hypertrophic or keloid scarring, or bleeding disorders in the injection area * Active inflammatory processes, infections, lesions (malignant or benign), or scars in the injection area * History of streptococcal diseases (such as recurrent sore throat or acute rheumatic fever) in the past 6 months * History of autoimmune/immunodeficiency diseases, or use of immunosuppressive drugs during the 6 months prior to or during the study * History of surgery or trauma in the injection area within the past 6 months * Use of antiplatelet drugs within 72 hours prior to treatment, or anticoagulants within 2 weeks prior to or during treatment * Use of drugs that reduce or inhibit hepatic metabolism (e.g., cimetidine, beta-blockers) due to the presence of lidocaine * Pregnancy, breastfeeding, or plans to become pregnant in the near future during the study * Undergoing or planning to undergo cosmetic treatments in the near future during the study, such as: 1. Botulinum toxin type A injections below the zygomatic arch during the 6 months prior to study entry 2. Previous injections of temporary dermal fillers (e.g., bovine collagen, hyaluronic acid) in the facial area within 1 year prior to study entry 3. Use of calcium hydroxyapatite, poly-L-lactic acid, or permanent fillers (e.g., silicone), or fat injections in the injection area at any time before or during the study