These flaws are a good indication that a sapphire is real. [substeps] Lab-created (fake) sapphires do not have inclusions of this nature, and some natural sapphires don't have flaws either, but if you find flaws it is real.
[header] How to determine if a sapphire is real [title] Look for flaws and inclusions. [step] Use a jeweler's magnifying glass, at least 10x magnification, to inspect the sapphire closely. Natural sapphires form with tiny bits of other matter in them, so look for small specks and blemishes.