Yes—this look can be made in-camera, but not necessarily with a tilt-shift lens. In the example discussed, the image was reportedly made with a standard 50mm lens using freelensing: the lens is detached and held tilted in front of the camera, creating an angled plane of focus and very strong blur.

With a tilt-shift lens, the effect comes from tilting the lens so the plane of focus is no longer parallel to the sensor (Scheimpflug principle). For portraits, photographers often use a strong tilt, focus manually on the eyes, and accept that much of the rest of the frame will fall rapidly out of focus. It’s creative, but difficult—especially with moving subjects and when working quickly.

The main challenge is precision: getting the exact part you want sharp while everything else falls away in a pleasing manner takes a lot of practice.

You can imitate this in post-processing, but it won’t be identical to the true optical effect. Software can simulate selective blur, yet the real look from tilt or freelensing has characteristics that are hard to match perfectly.