I rock a 212 and it's enough for me. Anything more and I would consider liquid cooling or more fans.
On my setup I have it where the air is "clipped" away from the heat sink and blown off in all directions, then vented accordingly. It's all about moving volumes of hot air away from the cooler and replacing it with cool air. A bigger heat sink won't make much of a difference after a certain point because it will populate a larger volume of your case with that hot air and hinder airflow.
That pic is ri-donkey-diculous! The purpose wasn't just defeated, it suffered a mortal kombat level fatality!