It's perfectly fine to just repair what's bad. Of course, there's a point where it's not worth it, but if it's just small areas then...
Whether it looks bad or not depends on the skill, difficulty level, what paint you use, and how meticulous you are. If it's smooth and flat, it's relatively easy to make it "invisible." If it's, for example, broom-finished, it's almost impossible to get exactly the same texture, but with a bit of finesse, it will likely be good enough for most people.