Is the woman on the left 'less real' than the woman on the right simply because she is a cardboard cut out? After all these two woman are merely shapes, outlines and variations of grey on a two dimensional photograph.
One distinction I make about fake and real in photography, particular when photographing people, is the question if action is created for the camera or if action is captured by the camera. The ice cream hugging women's smile is created for the camera, while the other women's facial expression is captured by the camera (albeit altered through my presence). I generally ditch my photographs where I have been to slow and given people the chance to put on a show.
The concept of fake versus real within photos and their ability to attract and sustain attention is a subject for another day.