Preview is a viewer with annotation functionality. An annotation does not modify the underlying PDF and so it is not much use for redacting or censoring. What you need is something that can edit PDF content.
Regarding pixelation: When redacting a PDF it is usually done with white or black bars (removing, not covering, the text underneath). Redacting with pixelation or blurring is usually done with an image editor (including many screenshot apps). But, with pixelated text, the original may well be partially recoverable. For unrecoverable redaction/censorship you need to remove all evidence of the redacted material.
Start with Adobe Acrobat (very not cheap). PDF Expert (less not cheap) is well liked. I use Nitro PDF Pro, but wouldn't really recommend it as value for money (I bought it when it was much cheaper).
As a viewer Preview is pretty good - it is fast and accurate for nearly all PDFs and image types. Adobe Reader is more accurate at following all PDF standards.