Katie, great question! I care very much about how my food looks, so I'm a habitual garnisher though I don't think all food actually needs augmentation--sometimes the components of the dish and their arrangement on the plate itself supply all the color, texture and detail that's needed--think pot au feu with a few crunchy blanched snow peas and real baby carrots with a bit of the stem left on. The ingredient list is where designing the plate actually starts.
Also, a lot depends on the character of the dish--is it comfort food, bistro food, or high end dining? Each calls for different levels of I'll go to different levels of trouble for each and perhaps slightly more so if company's coming, but I'm not even sure that's right since what I do is not to impress others but mostly to please myself. Probably have never done anything very elaborate, though: deep-fried black kale leaves to serve on poached fish, a large fat onion ring to go on a steak, slivered lengths of dried eggplant skin for a pale mediterranean dish--beyond parsley and other herbs that's the kind of thing I do. It's always edible and pertinent to the food on the plate. I know Bob would attest that he never stares down at a barren, all-beige, three-plop presentation.