I run my own mail server for receiving, but send through a commercial provider (Fastmail). I also use user-sub@domain style email addresses. If I have occasionally have to send email from those addresses, I edit the From line in the Fastmail web interface or my email client.

I don't have a problem setting up a full email server, but I don't want to babysit it for just one person using it. I have too many real life obligations these days to try and fix the mess if a problem would arise.