The shot came from the gun of Thomas Culp, her husband. His failed attempt at a murder-suicide sent him to prison for seven years -- and left his wife struggling to survive.
Watch "Good Morning America" Friday, May 8, for an exclusive interview with face transplant patient Connie Culp.
Culp did survive, but while the damage to her face occurred in an instant, her unlikely journey to recovery would take far longer. Over the next four years, she endured dozens of surgeries. These procedures repaired some of the damage, but Culp remained disfigured and unable to eat or breathe on her own.
So when Culp, who became the first patient in the United States to undergo a face transplant operation last December, appeared publicly to thank the doctors who performed the surgery, the occasion was an emotional one.
"Well, I guess I'm the one you came to see today," said Connie Culp, now 46, of Ohio at a Tuesday press conference at the Cleveland Clinic, where a team of surgeons performed the surgery five months ago. "While I know you all want to focus on me, I think it's more important you focus on the donor family that made it so I could have this Christmas present, I guess I should say."
The 22-hour surgery, which took place over two days, garnered widespread media attention shortly after it was completed. The operation was the world's fourth foray into face transplantation surgery. Culp's identity was not released at the time of the surgery, but today she introduced herself to reporters by her first name.
Currently, doctors are waiting to see how much function Culp will regain as the nerves in the graft continue to regenerate.
"We have to wait a little bit," said Dr. Maria Siemionow, the Cleveland Clinic surgeon who led the team that performed the operation. "It is a major reconstruction ... over the next six to 12 months we will see the animation coming back to her face, but even as she is right now she's just one of us."
Face Transplant Patient Is Resilient: Doctor
"She has nose, she has eyelids, she has lips ... what else [could] you want?"
Culp required the surgery from injuries she sustained when she was shot in the face in 2004. The episode left her unable to eat, smell, or taste, according to a statement from the Cleveland Clinic. Culp was also unable to breathe without a tracheotomy.
"I just want to say when somebody has a disfigurement and don't look as pretty as you do, don't judge them, because you never know what happened to them. I was shot," Culp said.
Dr. Kathy Coffman, the psychiatrist who worked with Culp, said she was a resilient patient, having been through 27 other procedures before the face transplant, and she believes Culp will be a good ambassador to other potential patients.
"She is a very down to earth person, and she was able to approach people before she had the surgery, when she had been injured," Coffman said. "Her resilience was key."
"I'm sure she will be willing to meet with other patients [and] candidates," Siemionow said.
Meeting the Challenges of a New Face
Though the surgeons regard Culp's recovery as a success so far, the new face means a lifelong adjustment. Culp continues to take powerful immunosuppressive drugs to reduce the risk that her body will reject her new face. She already endured a minor episode of rejection about a month and a half after the surgery; fortunately, doctors were able to treat the problem quickly with high doses of the anti-rejection drugs.
Culp's new face is not done changing. In the coming weeks and months, doctors expect swelling to go down and even more function to return. The advances will be gradual, and they will require determination on Culp's part to maintain exercise therapy and continue to monitor the graft for any potential problems.
But Culp is no stranger to challenges. Since her injury, she has learned to read Braille. She has adapted to her new life using special serving cups, talking calculators and other tools to manage daily chores.
Face Transplant Patient Still Faces Complex Issues
Still, she said that she occasionally still feels frustrated by her situation.
"Oh yeah, I wouldn't be human if I didn't," she said.
She said that she has forgiven her husband -- and at his 2005 hearing, she said that she would possibly take him back after his seven-year prison sentence.
"I don't regret any of that," she said on her relationship with him. "I'll always love him, he was my first love."
Face Transplant Operations Go Global
Frenchwoman Isabelle Dinoire was the world's first patient to have a face transplant and appears to be doing well today. After Dinoire became the first recipient of a partial face transplant in November 2005, similar surgeries in various countries have followed.
Most recently, on April 9, a team of surgeons and staff led by Dr. Bohdan Pomahac of Brigham and Women's Hospital in Boston replaced a large portion of the face of a man who required facial reconstruction after injuries he suffered in a severe traumatic accident. In a marathon 17-hour surgery, the Boston team transferred the nose, hard palate, upper lip, facial skin, muscles of facial animation and the nerves that power them and provide sensation from a deceased donor to the unidentified recipient.
Prior to this, on the weekend of April 4, a team of doctors at Henri Mondor hospital in Paris performed the world's first simultaneous partial-face and double-hand transplant on a 30-year-old burn victim.
Good Morning America producers contributed to this report.