IMO outside of running wires - neither trivial nor cheap, obviously, given the multiple trades involved, and structured cabling doesn't seem to enhance the resale value of a home either - the level of setup complexity has gone down substantially with the current crop of processors compared to the early days of surround. The time from first turn-on to listen-for-enjoyment for a system with 14 processed channels (7 bed, 4 height, 3 sub) is about 2.5-3 hours for a very listenable result with Dirac Live+Dirac Bass Control or RoomPerfect. Audyssey can get you a lot of the way there in similar time if you have the iOS app, but will only handle 2 subs and IMO not as elegantly as DLBC or RP does. You also will need to manually fix the factory target curve for every channel by removing the midrange dip and drawing in a bass curve that more closely approximates the bass response when you place a legit full-range speaker in that room.
I have found the additional 4 ceiling speakers - ours are in the ceiling, but placed and functioning as heights per Auro-3D guidelines - beneficial for both two-channel music (upmixed with Auro) and the native Atmos tracks in Apple Music (dropped Tidal because Apple's immersive catalog exceeds theirs). Movies sound great too, but that isn't my personal focus or a great interest. Others' opinions may vary, but I would do it again. Or rather for a third time, as I did not consider omitting the height layer in the current home.