After analysing their concept of humanitarian plastic surgery, the authors present their personal experience which started in the 1970s, concerning two aspects: in the field (Burkina-Faso, Mali, Niger) and in Geneva, Switzerland, where the more difficult cases are operated. They illustrate their approach by a clinical case of sequelae of noma. They analyse the problems and/or questions raised by humanitarian plastic surgery: sufficient training, choice of surgical techniques, postoperative follow-up, assessment of the results obtained, possible innovations.