Yeah, I'm happy with mine (didn't go Molten, preferred the simplicity of the standard skin).
Top row: Level up QWER
Middle row: Emotes
Bottom row: Self-cast QWER
Three middle mouse buttons: Smart cast items 1-3
The side buttons are all used for things that usually require ctrl or alt by default, and they are not things that typically need rapid-fire combinations. They aren't that easy to use rapid-fire, so I believe it's easier to use the side buttons in this way. It's much faster to find the right Naga side button than it is to try to do a two-key command with just your left hand.
Mouse button emotes have made an enormous improvement to my LoL experience.