My vote: a mold. The symmetry is so exact, I'd be inclined to think its a mold, but a steady hand and the right shapes in a tray would produce the same finish. Either way, it's divine!
The border beads and dots have exact placement so I think those are a mold. Done by hand there is always a slight variation somewhere. would love to find the mold.
This photo popped up in another thread a while back. I think (and thought at the time) that the individual ovals and teardrops were piped on a flat surface with RI, left to harden, lustred, and then stuck to the cake. The round balls are pearl dragees stuck on around the ovals.