Face Transplant Patient Connie Culp Undergoes Final Procedure, Learns to Smile Again

After 6-Year Ordeal, Connie Culp prepares to head home.

Aug. 26, 2010— -- For the first time since her face was destroyed by a shotgun blast in 2004, Connie Culp can now walk down the street and smile.

The recipient of the first-ever face transplant in the United States, Culp underwent her final facial surgery in mid-July, the last of nearly 30 procedures that have rebuilt her damaged skull and given her the ability to face the world again.

Culp, the 47-year-old mother and grandmother, will soon leave the Cleveland Clinic which has been a second home to her since her transplant surgery on Dec. 10, 2008. Just two face transplants have been performed in the U.S. and only 12 worldwide.

See Connie Culp's remarkable progress tonight in an exclusive interview with Diane Sawyer on "ABC World News."

"You said to me that you wanted to be able to walk around and not have anyone look at you," said Sawyer, who first interviewed Culp in May 2009. "And you told us about a child -- a little girl who had said to her mom, 'Monster, mommy.' Happen anymore?"

"Not anymore. Nobody pays any attention to me," said Culp. "Just another person on the street."

Her most recent procedure was similar to a facelift, though it was far more complex than any cosmetic surgery procedure. A team of 5 surgeons worked for four hours at the Cleveland Clinic, tightening Culp's face and removing the extra flaps of skin that hung from her cheeks and chin after the transplant surgery.

The donor's family still wants to remain anonymous, so all Connie knows is that her transplant came from a woman, roughly her age.

Nerves Regrow, Allowing Culp to Smile

Since her 2008 procedure, Culp has made remarkable progress. Her tracheotomy tube has been removed, and she's now breathing on her own. Her facial nerves have regrown, allowing her to speak more clearly, eat steak, and even smile.

"I have to say, I just can't get over how beautiful it is," Sawyer said.

"They did a good job, didn't they?" Culp answered with a grin. "You know, I think they made me look somewhat like ( I ) used to before. Because I had the high cheekbones."

Feeling Returns to Connie Culp's Face

A year ago, Culp couldn't feel a tear trickling down her face, but now the sensation has returned. Culp said she can feel her face prickling as the nerves regrow at a rate of one inch per month.

"I massage it every day and massage the scars, cause that will make it go down," Culp said.

"It's just still puffy cause I have that second gland in there," she said gesturing to her jawline. "It'll go down eventually."

Her doctors have shared in Culp's joy as she's made an astounding recovery.

"This is amazing both technically, surgically, but also philosophically. The face of someone else is being adopted and accepted by the face of the recipient," said Dr. Maria Siemionow, the Cleveland Clinic surgeon who lead the team that performed Culp's transplant surgery. "You can see a live person who is happy her life is back."

Concern Over Transplant Rejection

The greatest danger Culp faces now is a rejection of her transplant. Two face transplant recipients died after rejections, and Culp has now had two scares, including one in the last year.

"My face turned red," Culp recalled. "I can't let that happen to me again. You can feel it. And you know when you're going to get sick. It's almost like a cold, so I have to watch."

Though she'll undergo regular biopsies to monitor her transplant and take anti-rejection medications daily, Culp's doctors now expect her to lead a normal life.

Despite Attack That Stole Her Face, Culp Says She Still Loves Her Husband

Culp's long ordeal began six years ago, when her husband, Thomas Culp, shot her in the face with a shotgun before attempting suicide himself. The gunshot ripped away 80 percent of Connie Culp's face, including her nose, cheeks, he roof of her mouth and one eye. Hundreds of bone fragments and shotgun pellets were lodged in her face, with only her upper eyelids, forehead, lower lip and chin remaining.

Her husband was sentenced to seven years in prison, though he's coming up for parole this year.

When Culp first spoke to Sawyer in 2009, she said she forgave her husband on the day of the attack. Though she's now going through divorce proceedings, she says that even today, she still loves him.

"I always will [love him.] I mean, I have two kids to him," Culp said. "But you know what? I cannot be with him anymore."

Connie had a brief conversation with Thomas Culp on their anniversary, but she's determined to move on, declining to talk about the attack six years ago.

"I won't let anybody talk about that," said Culp. "I spent six years thinking about it. And you know what? Now, it's a new beginning. I have a new face. I'm a new me."

Vision Recovers as Culp Looks to the Future

Even the vision in Culp's remaining eye has improved since the transplant.

"I can see your hair today," Culp told Sawyer. "But I can't clarify your face. It's a little bit dark in here."

"They say it might [get better,]" Culp said, though "they don't know why I have the eyesight right now, like I do. So I'm lucky that way."

As she prepares to leave the Cleveland Clinic, Connie Culp is also seeing her future more clearly. She plans to work as an advocate for women who have been abused, and she may even become a motivational speaker.

"What would you say today to abused women, if you were talking to them?" Sawyer asked.

"Pay attention to what your man's saying. If he says he's going to do something, he will do it," Culp said. "It does not get better. It does not get better."

And as she thinks of the future, Culp is also able to look back on the past six years and see the blessings.

"I never dreamed I'd have a nose, a mouth. I had nothing. I had a hole in my face, you know?" Culp said. "I am so thankful... I don't care what religion anybody is. We all have a god, and He's great. I'm lucky, cause a lot of people love me."

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