Mine are mostly flat. I want to get as many layouts in one album as possible and if they are too bulky I can't do that! I used to use bulky items all the time when I first started - buttons especially - but not so much anymore. Foam tape is about as thick as it gets!
I like dimension but not bulky. Not after looking through older albums and seeing how the bulky items dent the pages near them. I've even gone back and pulled bulky items off! I like to layer and I will use foam tape.