When does a photo become and image?

I recently watched a demonstration on Photoshop where a photo was drastically altered, with doors in walls moved, drainpipes straightened, windows moved or replaced with matching stone wall, shadows altered and a walking figure introduced. All clever stuff, but completely devoid of reality. If we get off the peg walls, windows, doors, streetlights, people etc etc. and make a picture on a PC, is that photography? I'm not against Photoshop or other similar products, making subtle changes to photos has been standard since the first camera. Has it now gone so far that camera technique and composition are becoming irrelevant?
Dec 16, 2019
Two things:

1. If you had not seen it done would you know?
2. If this was film photography do you think some of the greats would wish they could have done that?

I will answer 2. Yes, damn right they would. Darkroom masters would have loved to be able to do what we do now.