Applying a smudge of pink lipstick to her new, shapely mouth is something of a milestone for Connie Culp.
Before her pioneering face transplant in 2008, wearing lipstick – or any makeup – would have been an impossible task after her top lip, nose, roof of her mouth, one eye and both cheeks were destroyed by then husband Tom, who brutally shot her in the face after flying into a rage.
Now, the 48-year-old, from Ohio, who was the first person to receive a face transplant in the U.S., has bravely decided to talk about the domestic abuse and terrible shooting she endured at the hands of the man she says she still loves.
Her decision to speak out comes as Culp, 52, was last week released from prison after serving just seven years for the horrific crime.
New lease of life: Connie Culp, who received America’s first face transplant after she was shot in the face by her former husband, back before the surgery in 2008, left, and today, right
Transformation: Ms Culp’s profile before the transplant shows how her nose was completely destroyed, left, and right, how she looks today
Describing the moment her life changed forever, Ms Culp said: ‘I remember everything. That’s what the doctors can’t believe.
‘I remember him lifting the gun, and what he said to me, and then firing.
‘It’s an image that will never leave me, for the rest of my life. It’s the moment everything changed forever.’
Beautiful: How Ms Culp looked before the horrific attack in 2004
As well as suffering horrific facial disfigurement, Ms Culp was also left almost totally blind in the 2004 attack at the bar in Hopedale, Ohio, which the couple owned and ran together.
The signs, she says, were there before Culp attempted to take her life.
‘He only hit me a couple of times ever. It was the bullying that was worse.’ Ms Culp said.
‘Maybe it was a warning for things to come, but I never imagined what eventually happened was even possible.’
But, despite everything her ex-husband has done, Ms Culp says she still loves him.
‘I’ll probably always love him because he’s the father of my kids,’ she admitted. ‘But I can’t handle being around him.’
The mother-of-two recently returned to the bar for the first time in eight years since that awful night when Culp snapped.
‘He was jealous because everyone seemed to like me so much,’ she revealed. ‘It wasn’t really men. I was popular with the girls who worked with us and most of the customers.
‘I think it just used to make him jealous. And money was tight with the bar. We owned it together and it used to put a strain on us.
‘Sometimes he used to break things in the house when he’d get mad. Sometimes my things, like a trophy I’d won in a karate tournament.
‘And then that night something just snapped. We were at the bar and he was mad. Then he just got his shotgun and shot me.’
Milestone: Despite not being able to see that well Ms Culp applies lipstick to her new, shapely mouth so she can ‘hold her head up high’ when she goes out
It’s important to Ms Culp to appear like she’s coping.
‘It’s the way I keep going,’ she said. ‘I don’t want people to feel sorry for me. I want to be treated the same as I was my whole life, before the shooting.
‘If I dwell on the past I’ll have no life to live.’
And despite rarely showing others her emotions, when talking about Culp listeners see a flash of anger while sadness and disappointment creep into her voice. 
After shooting his wife, Culp put the gun in his mouth and pulled the trigger causing severe injuries to himself. But, like his wife, he survived.
‘It was all just a waste,’ Ms Culp said.
‘He’s never acknowledged what he did. He just blames it on everyone else.’
After the shooting in September 2004 Ms Culp spent months in hospital as surgeons repeatedly tried to fix the damage caused by the gun blast.
With her children Steven, 30, and Alicia, 28 at her side, she battled on, always taking comfort in the miracle that she had survived.
She even visited her husband in prison to comfort him. But despite her unshakable determination to forgive, the events had changed things forever.
Brave: Ms Culp outside the bar she and now ex-husband Tom owned in Hopedale, Ohio, where the shooting took place. The 48-year-old says she still loves him despite everything he has done
‘I knew then it was over,’ she said. ‘I haven’t shaken that badly since he shot me. I can drink four pots of coffee and not shake. But around him I couldn’t control it.’
Chillingly, Culp even got angry with the mother of his children for telling the truth to the police about the shooting. 
‘Tom said: "I wouldn’t have told on you" and I said "I wouldn’t have shot you",’ Ms Culp said.
‘He’s mad because I make jokes about it,’ she added. ‘How do you think I’m going to get through this?’
Anxious about his then potential release this month, Ms Culp finally made their divorce official in May and moved out of the home they shared in Bloomingdale, Ohio, in her bid to move on.
‘He’ll probably move back into the old house,’ Ms Culp said. ‘His family still own it. He has a restraining order but nobody knows what he’ll do.
‘We’ll just have to wait and see.’
As well as her husband Ms Culp also had to endure children reacting to her damaged face with horror.
‘Children would say I was a monster,’ she said. ‘They didn’t mean anything by it. They were just being kids, but it made me feel worried.
‘I got through it by just trying to look at the brighter side of things. I was alive, and I had my children and grandchildren.’
After all she had been through, Ms Culp was eventually put on the face transplant waiting list in October 2008 at the highly prestigious Cleveland Clinic, Ohio. 
Dr Chad Gordon, one of eight surgeons involved in the procedure, said: ‘The problems were that we needed a deceased woman from the local area, so that we could get the donor’s face to Connie quickly.
Chilling: Sitting on the piano, Ms Culp poses with Culp, who is brandishing a gun, their daughter, Alicia, left, and son Steven, right, for a 1920’s style photo. The signs, she says, were there all along and he subjected her to dreadful verbal abuse
Horrific: A CT scan shows the extent of Ms Culp’s injuries after her husband blasted in the face, left, and after surgery, right
‘We needed someone from her age group and of the same blood type, and one who was registered as a donor.
‘In the U.S., not many people sign to be donors, so the odds of finding a match were always slim.’ 
But on December 10, 2008, just two months later, the team were shocked when they found a match.
A local woman – whose family Connie has now met – had died from a heart attack. It was a chance of giving Connie what she had waited more than four years for.
Calling her to tell her to race to the clinic, Dr Gordon reminded Ms Culp the procedure could end her life.
‘I already had one miracle by surviving the shooting,’ she said. ‘So I thought someone up there might have another one for me.’
The medical team, led by top surgeon Maria Siemionow at the Cleveland Clinicbattled for over 20 hours to attach her new face. 
Doctors hollowed out the damaged section of her face before replacing it with the donor’s which they harvested using a hand-drawn template and plastic model of Ms Culp’s face to guide them.
This entire bone segment – with the donor’s face attached – was raised in one large piece and included both cheek bones, a new upper jaw, a new palate, portions of both orbits, and some donor teeth.
While the transplant has improved things, Ms Culp knows her serious medical battle will last the rest of her life.
She said: ‘Everyone assumes you’re better and forgets about it after the transplant. I hope to show the world that this isn’t the case for people like me.
‘You still have to fight and live with the memories of why you needed one every day.’
A nurse visits Ms Culp three times a week to check her health and make sure her body isn’t rejecting her new face. 
Each day she also takes a cocktail of prescription drugs to help her body cope.
With a tiny amount of sight left in her left eye, she struggles to see and finds it hard to do most daily tasks alone.
But she has a number of techno gadgets to get by.
‘A talking pill box in my bedroom tells me when it’s time to take my medicine and dispenses the right doses,’ she said.
‘My talking alarm clock lets me know what the time is every hour, and a clothes scanner tells me what colours my outfits are, so I don’t mismatch.
‘Otherwise I’d be going out with odd socks on.’
Ms Culp also walks with a cane, while her local shopkeepers help her to choose the right brands of food.
A document magnifier helps her to see her old family photographs of happier times, and read letters and bills.
And after taking her medicine each day, Ms Culp carefully applies her makeup, staring at her reflection in her bathroom mirror.
‘Now I can go out and hold my head up high. It’s improved my looks so much. It’s hard for me to see exactly what I look like because I can see only shapes really, with no definition.
‘I know it’s not my face, but I feel thankful that I have one now.’
She enjoys a new love of life, playing with grandson Maddox, four, and spending time with her children Steven and Alicia, who helps with work around the house. 
Ms Culp regularly tries one of the exercises she needs to perform to keep her face adapting.  ‘I hold a toothbrush between for my lips for as long as I can but I can only do a few seconds,’ she said.
‘It’s the little things that are my goals. I want to be able to drink a milkshake through a straw again. But I haven’t got enough strength.
‘Smiling is also tough. I can do angry when Maddox is being naughty, but I want him to see me smile too. That’s another goal.
‘They say it takes more muscles to frown than it does to smile, so I don’t know why so many people walk around frowning all the time. They should just smile because it’s less work.’
Her other goals have involved helping others. She attends conventions as an ambassador and promotes organ donation, which made her life bearable again.
‘If my work can raise the number of donors and get transplant for others, then that would be a good thing,’ she said. 
Ms Culp’s fighting spirit has earned her admiration from around the world.
‘I was given a miracle when I survived the shooting,’ she said. Then I got a second miracle when I survived the face transplant.
‘It’s still tough, but my life is so much better now.’
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