When you do the VMOD, you'll add considerable heat to the GPU. However, this isn't too much for a normal heatsink/fan combo solution to handle. I'm not sure if you've read this...
http://www.procooling.com/articles/h..._ii_mods.shtml
This is what I did. It stayed nice and cool
. However, some people have done the VMOD and gotten to the same speed as me w/out the peltiers. Why not try one of those low profile alpha coolers? Or you can put a big sucker on there like I did too...
-Kevin