For my fashion and model stuff, I would eliminate pimples or whatnot, sharpen the image a little (shouldn't need a lot), and play with curves till the contrast looks like what I saw when I was composing the image. Some cropping may be done as well.
For anything else, I mostly just play with curves till the scene looks more like what I actually saw. Every once in a while, I'll punch up the colors just a little, but it's the same as when I used Kodak E100SW or Agfa Ultra 50. It's true that photographers have always enhanced their images in some way, but it used to be little tweaks - filters, film selection, darkroom tricks -and not the outright ridiculousness that I see now (but that's another thread, albeit a rehashed one, lol).
My only "guilty" shots are these two (may not be work safe!!!!):
Gabriel J. Diaz Photography. A bikini, and a towel on the pavement (to protect the uber-pricey new shoes we had on loan) had to be removed to make the picture that I wanted.
On the other hand, my current avatar is pretty much straight out of the camera, as are 99% of my images.