I have RAM heatsinks installed on my card. The RAM doesn't get hot anyway because I didn't increase the vDimm.
The stock cooler had just contact to GPU and RAM with pads. Other parts of the frontside weren't cooled by it. I just have a 120mm fan below the frontside at the bottom of my chase to blow cool air from outside onto the graphics card.
The back of the card gets really hot because here is no nearly no airflow. But these parts there had already no sinks installed with stock.
But you are right, maybe ill get some small sinks on the mosfets
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