Striae Distensae is characterized by skin atrophy and there is no successful treatment that promotes its regeneration. Fat grafting has been used with positive results in volume augmentation and tissue regeneration, based on its content of mesenchymal cells. The authors studied tissue regeneration with autologous lipoaspirate graft, needling and both techniques combined, as well as compared four lipoaspirate processing methods. Clinical and histological evaluation was accomplished. The best clinical outcome was obtained by lipoaspirate graft and needling combined, while needling alone and grafting alone had no clinically significant improvement.