This is education, not advice
The information here is written for the general reader and does not replace a personal medical consultation. It cannot tell you whether your concern is texture, laxity or scarring, or whether either technique is appropriate for your skin, your health or your circumstances.
Neither technique is a default
Nothing on this site should be read as ranking one technique above the other, or as describing the heated technique as the one to choose because it is newer. They share an instrument and reach different tissue, both carry real risks and real costs, and the choice follows from an examination rather than from a clinic’s equipment.
No outcome is guaranteed
No treatment can be guaranteed. How much texture improves, how long the change lasts and how a particular skin responds to heat all vary between individuals. Results fade with time and further ageing, and maintenance treatment is the normal expectation rather than a sign that something went wrong.
Pigment, heat and infection
Both techniques can leave skin darker or lighter than it was, and heat increases that risk. Heat delivered at depth can also affect fat beneath the skin, a change that does not reverse. Infection can be introduced through the channels the needles make, which is why sterile single-use needles are not negotiable. A spreading redness, warmth, discharge or fever after a treatment needs same-day medical care.