It's a photo, then "photoshoped" to soften the edges and add contrast to the face by giving it more light. Don't ask how 'cause I'm Photoshop-challenged.:lol:
I have seen similar ones done in studio completely with "old-school" practices. I mean you can use softening filters, different light sources, etc. What surprised me was the sharp blade reflection while all the other stuff was soft. As I said, I was just curious... :)