(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 wasn'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 wouldn't be human if I didn'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. Don'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 cannot 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
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