( CNN ) -- Doctors chose a woman who survived a shotgun wound to her face as the first recipient of a face transplant after treating her for nearly four years . This image projects what Connie Culp , 46 , may look like two years after the face transplant . Connie Culp knew of the Cleveland Clinic 's interest in face transplants and approached the medical staff , doctors said at a news conference Tuesday . Dr. Maria Siemionow , the Cleveland , Ohio , hospital 's director of plastic surgery research and head of microsurgery training , had more than 20 years of experience in complex transplants . By 2004 , Siemionow was looking for the right candidate for a face transplant who was n't doing it for vanity . `` They are not looking to go out on the street and be beautiful , '' Siemionow told CNN in a 2006 interview . `` Some of these patients , when they were interviewed just said ' I want to walk on the street and just make sure I am not sticking out . ' They just want to have a normal face . '' The doctors examined the patient 's history , motivation and ability to understand the risks of the transplant . And they found Culp to be an ideal candidate . Five years after a gun blast shattered her nose , cheeks and upper lip , she had a band of scar tissue extending across her face . `` The most devastating of all was the fact that society had rejected her and children were afraid of her , '' said Siemionow , who led the December 10 transplant operation . See before and after photos of Culp » . Culp , a mother of two and a grandmother , told her doctors she could understand that some adults would shun her . `` But what really bothered her the most were children -- the children that shied away from her , '' said Dr. Frank Papay , the chairman of Institute of Dermatology and Plastic Surgery at the Cleveland Clinic . `` That sense of innocence , and her not being able to see that innocence really , really affected her . '' The shooting . In September 2004 , Culp 's estranged husband shot her in the face in an attempted murder-suicide outside a restaurant in Hopedale , Ohio , according to CNN affiliate WTOV in Steubenville , Ohio . Culp was 8 feet away from her husband , Thomas Culp , when he pulled the shotgun 's trigger . He then turned the weapon on himself , according to local news reports . They both survived . Thomas Culp was sent to prison . Despite her wounds , she told WTOV in 2008 , `` I 'll always love him . He was my first love . '' At the same time , Culp said , she felt angry . `` I would n't be human if I did n't . I forgive him , but I have to go on , you know ? '' After the shooting , Culp recuperated in a hospital and in a personal care home for two years . Culp told WTOV she had vision problems and was learning Braille . Her approach to life was to `` keep motivated . Do n't sleep your life away -- that could have happened . I could be depressed . I 'm not . '' As she spoke , her breaths emitted a small whistle from her tracheotomy tube , which protruded from a surgical opening in her neck . `` I can not smell . I will never be able to smell , '' she said in the interview . Culp was wrong . How doctors transplanted a face . The doctors at the Cleveland Clinic analyzed Culp 's injuries using CAT scans and developed plastic models of her skull . They practiced face transplant operation on cadavers several times . Culp met with the hospital 's surgeons , ethical committee members and psychiatry and psychology specialists who determined that she was an ideal candidate for the surgery . Then , the wait for the right donor began in 2008 . `` We thought we were going to wait a long time because we had to find a Caucasian female in her mid 40s to match Connie , so we expected a year before we were able to find a donor , '' said Papay , who is also head of craniofacial surgery . `` Well , three to four months later , I got a call at around midnight from Dr. Siemionow saying ' I think we have a donor . ' '' The family of a brain dead woman granted permission to use her face . He likened the preparation for the December transplant to a rocket launch , saying , `` Everything was prepared beforehand very , very , very carefully . '' Surgeons sheared out the donor 's mid-facial area including the lower eyelids , cheekbones , the nose , some of the sinus and the whole upper jaw , with the blood vessels . Watch CNN 's Dr. Sanjay Gupta discuss the face transplant » . When it came time to move the donor 's parts to Culp , they had to see that the donor and recipient parts aligned . `` One of the ways you can tell that is how your upper teeth fit to the lower teeth , '' Papay said . `` We knew it was like a hand in a glove , exactly where we needed to be . '' They secured the bones into Culp 's face using titanium plates and screws . Then the microvascular surgeons attached the vessels . They tucked the scars around Culp 's ears or underneath her eyelid , where they would not be visible . How the doctors operated » . Doctors added more skin than needed in case of tissue rejection . After monitoring Culp 's progress , doctors say they will remove the excess tissue and tighten her jawline in future surgeries . Contrary to science fiction and movies , the surgery did not make Culp look like the donor . `` If you just took the skin and transplanted it to the other patient , the bony structure is different , '' Papay said . `` If you took the bony structure and transplanted it on the other side , it ends up being a composite . So , it does n't look like the donor . It does n't look like the recipient . It ends up looking like someone new . '' Recovery . At this point , all the transplanted parts of Culp 's face are functioning except for her facial nerves , which are growing about an inch a month . Doctors anticipate Culp will be able to have full facial function -- and more expression -- by this winter . In physical therapy , she learns to train her nerves , make facial expressions , smile and purse her lips , doctors said . `` If you cry or you laugh or you smile , it 's not like you think about it . You just emotionally do it . So that 's a wait and see for us , '' Papay said . `` As far as the emotional one , that 's really the key issue . A far as when she laughs , cries and grimaces and gets angry at you ... what 's her face going to look like ? That 's the exciting part about it . '' Five months after the first face transplant in the United States , Culp lives at home . She has checkups with the medical staff once or twice a month and will do so for the next year , her doctors said . Initially , Culp used immunosuppressants that transplanted kidney , liver or heart patients would normally take . Transplant patients must take immune-suppressing drugs throughout their lifetime to prevent tissue rejection . But she showed improvements that enabled the doctors to reduce her regimen to one medication , doctors said . `` She 's taking her medications , '' Siemionow said . `` We know she is compliant . She cares about how she looks . She has her hair done in a new color ... She is full of life . She does her push-ups . She 's on the treadmill . What else can I say ? ''
Face transplant recipient was shot in 2004 by her husband . In a 2008 interview she told CNN affiliate that she forgave her husband . Doctors say Connie Culp fit criteria for ideal face transplant recipient .