Mastectomy is very common surgical procedure for breast cancer. The closure of transverse elliptical mastectomy incisions has been represented with numerous modifications since 1915. The technical challenge is to avoid a fold of skin dogging laterally ("dog-ear"). This might lead to off future discomfort and poor cosmetic result. However, various surgical techniques are reported to tackle this lateral dog ear, there is no standardized technique. We therefore conduct a systematic review of the surgical techniques with the aim of comparing the merits and limitations of every technique. The comparative study among 72 patients was performed in Bangabandhu Sheikh Mujib Medical University, Anower Khan Modern Medical College & Hospital and Care Medical College & Hospital, Bangladesh from July 2017 to January 2020. Patients were divided randomly into two groups: Group I underwent fishtail technique group (36 patients), Group II underwent modified suturing technique group (36 patients). The follow up periods were 1 month and 3 months post-operatively for determination of the presence of dog ear and patient's satisfaction regarding cosmetic outcome and comfortability. Incidence of dog ear in fish-tail plasty group patients was less than that for Group II yet the difference is not significant less (p value 0.001). In consideration of patient satisfaction, doctor satisfaction and patient comfortability were significantly higher in Group I than Group II (p value 0.476 and 0.001 respectively). Fish-tail plasty was significantly better in patient satisfaction, comfortability and doctor satisfaction than modified suturing techniques and it might be recommended following mastectomy in obese patients for improving cosmesis and avoiding discomfort due to redundant skin.