I'm going to say this is AI with inpainting. The focus on the face and bangs are too detailed compared to the surrounding area. As far as her vagina goes, it looks like it has a total depth of 2mm, which would be awesome if we were wearing labias like contact lenses.
Then there's definitive smearing on her choker which makes me believe it was an inpainting AI job, alongside the lack of LD picture noise along the labia, face and bangs.
However, the bangs could be clip-on's. The choker could have been smeared by a shitty healing brush tool. AI upscaling doesn't necessarily mean it was manipulated nefariously, just that it could have been used in Topaz and then downscaled. I have no arguments for the vagina depth, lack of noise on the vagina, or the choker smearing. Either way, the photo is definitely manipulated.