The aquia uses an adapter that gets mounted to the floor, then the toilet gets attached to the adapter. It's pretty simple. Any plumber should be able to handle it without problems. If you have a tiled floor, you might need a diamond bit to drill the mounting holes. If you don't then, it can take a long time to try to drill through some hard porcelain tile. WIth the right tool, it's quick and easy. As long as they are aware of that and come prepared, it should not take much longer than with a "normal" toilet. With the skirted design, the back is a little wider than most toilets and can cover the location where a standard supply valve would fit - it needs to be a little further off-center. This is easy during contruction, but needs to be specified to the rough-in people.