I am thinking it’s actually the boy who has been inserted into the picture. Also, I find it nearly impossible to believe that anyone would have used the original image (a positive, negative or Polaroid-type film) to make or assemble various alterations in this rendition. Most likely, all the person had to start with were two or more prints, which were scanned and then manipulated using Photoshop.
I never said the hardcopy originals were cut and pasted. It goes without saying that in Photoshop you use jpegs or other digital formats or scans of originals. Sheesh.