Perfect has four narrators, all of whom are high school students in Nevada: Cara Sierra Sykes, Kendra Melody Mathieson, Andre Marcus Kane III, and Sean Terrence O'Connell. Cara, Kendra, and Sean go to the same public school; Andre goes to private school. Their stories intertwine due of the suicide of Cara's twin brother, Conner.
Conner was one of the narrators of Impulse, to which Perfect is the sequel, and he's still alive at the beginning of the book. Cara, now a high-school senior, tells us what life has been like since Conner attempted suicide and ended up in a psychiatric hospital called Aspen Springs. With Conner gone, Cara bears the brunt of her parents' intense pressure to be—you guessed it—perfect. She gets straight As, is a cheerleader, and is going to Stanford in the fall. She's also dating a hot jock.
That hot jock is Sean, who's madly in love with her. He's also madly in love with baseball, and he's determined to follow Cara to Stanford by getting a sports scholarship. He spends most of his time working out, trying to get bigger and stronger. It's not going as quickly as he'd hoped, though, so he asks his drug-dealing older brother, Chad, to get him some steroids.
Kendra's also a cheerleader, and she used to be Conner's girlfriend, before Conner started sleeping with his teacher and everything fell apart. She's still in love with him, even though she hasn't seen or talked to him since he went into Aspen Springs. Like Conner, she deals with intense parental pressure, but in a different way—her mom wants her to be a pageant princess and runway model. She's afraid to eat, because she might gain weight and let her mom down. Her nose job is scheduled for spring break, and her plastic surgeon is Dr. Kane, Andre's mom.
Speaking of Andre's mom, she's wealthy, as is his dad, as was his grandfather. They're self-made rich people, and they expect him to follow in their footsteps. Secretly, though, he wants to be a dancer. The day Kendra goes to see his mom for her rhinoplasty consultation, Andre swings by the office to get some money, which he's told her is for clothes but is really for dance lessons (shhh…). There he meets Kendra's younger sister, the fast-talking, fast-living Jenna. Andre is immediately smitten, and they begin dating.
Cara goes snowboarding one day and plows into a snowdrift. A cute girl named Dani pulls her out, and Cara realizes that the reason she's never been attracted to Sean is that she's attracted to girls. She and Dani kiss, and it's all over: Cara's gay. But how can a perfect, popular cheerleader ever admit to being a lesbian? She's still a virgin, so she decides she'll sleep with Sean just to make sure she can't get into the guy thing.
This is a bad idea for a lot of reasons, not the least of which is that Sean's become addicted to steroids. He's increasingly unable to control his, uh, urges. So when he and Cara start to do the deed, and she changes her mind mid-makeout and says no, he rapes her. Because he's an idiot, Sean can't understand why she can't just get over it—and when Cara stops speaking to him, he starts stalking her.
Kendra, in the meantime, is going down the eating disorder rabbit hole. She finds some leftover prescription painkillers in the medicine cabinet and discovers that when she takes them, she doesn't care about anything, including food. What she does care about is the fact that her loser dad has decided to marry his much-younger girlfriend, Shiloh, who tries to ingratiate herself into Kendra and Jenna's lives. Ugh.
Lacking a father figure, Kendra hooks up with a new agent named Xavier, who promises her the world if she (1) loses weight and (2) sleeps with casting directors. She does both. The former is much easier when she starts taking the diet pills Xavier gives her. As for the latter, it's awful, but it helps her get modeling jobs.
Jenna's not a model or a particularly good student, but she's also lacking a father figure, and she deals with it is by getting random guys to buy her booze. Much to Andre's dismay, Jenna's got a serious drinking problem; she brings a flask on all their dates and has a habit of getting wasted and passing out while the night's still young. Andre loves her despite all this—or at least, he's really hot for her—so he tries to save her. As you might expect, this is impossible. The only time he's not thinking about Jenna is when he's in the dance studio.
Cara ditches Sean, sleeps with Dani, and realizes she's definitely gay. Sean, because he's a creepy stalker, stalks her to Dani's house, where he looks in Dani's bedroom window, sees them having sex, and takes pictures. He wastes no time texting the pics to all his friends, which means they circulate not only around the school, but all over the internet.
Cara presses charges, and Sean ends up in jail, though only overnight. Did we mention he's hearing voices due to steroid psychosis? Because he is.
Everything comes to a head when Jenna is raped and beaten on the same day Conner kills himself. Kendra has the world's worst day when she gets the news about Conner while sitting beside Jenna's hospital bed. Jenna lives, but everyone has to go to Conner's funeral.
Andre goes with Shantell, a dancer friend who went to high school with Conner. The other narrators are there, too, as well as two of Conner's friends from Aspen Springs, Tony and Vanessa (the other narrators of Impulse). Tony and Vanessa deliver a eulogy in which they tell everyone that Conner got tired of hiding who he really was, so he opted out. The narrators have epiphanies about how life's too short to be anything other than what you want to be—ain't nobody got time for parental pressure.