I love the look of needle turned applique...and have done some, but with hand problems...holding onto the needle for too long is a problem.
I do a lot of my applique with fusibles (not junk!) and I also love doing Mock Hand Applique by machine-which uses freezer paper, and stitched with machine...you have to look really close to see that it isn't done by machine...the edges of fabric are turned around the freezer paper so there are folded back edges, not fused. I have done a couple of large quilts with this method, and plan on doing more.