I definitely think they were worth it. I mean, if you look at women who were considered incredibly beautiful at some point in their lives (i.e. Sharon Stone), they don't necessarily have "chipmunk cheeks," but instead prominent cheek bones (which are slightly higher up). If you don't have that initially (and I'm jealous of the transwomen who do!), the only way to achieve that look is with some kind of implant/filler.
Do I think they're required to pass with ease (which is supposed to be the goal of FFS)? No not really. Do I think they help to add that "little something extra" that makes for an exceptionally good looking woman? It's likely they at least play a part.