As a YC founder of a venture backed company that lives in Hawaii now... Like everything in life, it's all a balance. My quality of life in Hawaii is hard to beat. My tech scene is hard to find. Which is why I come back to SF & NYC almost monthly. The travel is a bit of a pain, but I feel like I'm living a close to perfect balance.
It helps that I'm from Hawaii, so I'm not in "vacation" mode... I'm in "home" mode. Where I feel relaxed, comfortable, inspired & supported. From that place is where I run the chaos of a startup.