This thing works great. I don't have the large button inserts, but medium and small work well.
I used Stampin Up 2 inch and 1.5 inch punches to get images off the cover of and old DCWV stack. I still had to use the die that comes with the press to trim the circles to the perfect size, but with a tiny bit of tape holding the paper in place, it wasn't a problem. I turned the die a quarter turn and pressed 4 times to get a thorough cut. (I think using my Silhouette might be easier, but this was fine.). You don't have to press hard, just firm and make the turns.
So far my best results are from paper pad covers without Mylar. The finish in the covers is satin and beautiful. And the image sizes are nice.
I might go broke buying refills. It's kind of addicting.