Can the risk of muscle atrophy/volume loss following Botox around my eyes be countered?

To answer your concern about periorbital muscle atrophy with chronic Botox use: Yes, there is a risk of muscle atrophy with prolonged and frequent neurotoxin use. A skilled injector will be able to limit your risks by only performing treatments when needed and at the proper frequency/dose. Around the eyes, your orbicularis muscle is used frequently for spontaneous blink and forced eye closure as well as for facial expression. The counter to any noted atrophy is stopping neurotoxin use and continuing to live your life, the normal and frequent use of this muscle will allow it to hypertrophy the atrophied fibers. A consistent injector such as an oculofacial plastic surgeon will be able to monitor treatment effect and adjust dose or frequency to limit side effects.

Botox is not harmful. This has been used for years safely. There are side effects that can occur like causing skin sagging, and changing the mouth opening if not injected properly but that isn't harmful. I suggest dermarolling at home to give the skin Botox-like effects with at-home treatment. See an expert. Best, Dr. Emer

The muscle atrophy that you are referring to is typically associated with long term neuromodulator use. An experienced injector will monitor the effects of treatment and adjust amount needed accordingly which will minimize this risk. This is one of the many reasons to always select an experienced injector.