//// Update: DO NOT RECOMMEND KRITICAL PADS ANYMORE. Temps didn't last more than a few months and now its running hot again. I think my work was "bandaid" style with the thermal pads degrading quickly. I opened it up and the kritical pads had "sweat" a lot, with my thermal paste additions not maintaining good contact over time. Thermal putty is probably still the best. Now I'm back on the cooling quest and not satisfied with my work at all. ////
I may as well post my results since I found this thread so helpful. I have a 3090 ftw3 that I run nicehash on when not gaming. It was getting hot. I started out by adding fans and heatsinks to the backplate as memory junction temps were too high. I had settled on these settings to keep "cool":
mem +1200
gpu - 150
power 70
fans 63%
gpu temp 54.1c
mem junc 97.8c
hot spot 68.3c
Then I decided to ignore OP's advice and replace the pads. I bought the kritical pads custom set for 3090 ftw3 mentioned here. After replacing everything I had an immediate drop on mem junction to 86c, but the gpu and hotspot temps were running higher than before, especially when gaming (hot spot hitting 92c). So I went with edgeofsanity's add-paste technique and added some thermal paste (noctua nt-h1) to the top of the skinny pads on the outsides (vrm?). The photos in this thread illustrate it well. Anyways that seemed to help a lot. Potentially I did a better job with the gpu paste the second time, because using the same settings as before I get:
gpu temp 55.9c
mem junc 83.8c
hot spot 69.8c
Huge 14c drop on memory junction temps! So it ended up working out well for me with the custom-cut kritical pads and a bit of thermal paste to help bridge any gaps. It was also easy to do with these detailed write-ups. Thanks for all the info here, I can finally rest from my cooling quest.