The installation of the 2 Acquias I bought was a lot more difficult than expected. Luckily for me, they were installed on the 2nd floor, so even though some more holes had to be drilled in the floor tile in one bathroom, there wasn't a slab underneath -- that would have required some serious drilling! We had a height limitation of 30" under a shelf that is an extension of our vanity top in our powder room (which is on slab), so we ought an Ultramax elongated for there. That installed in no time flat. Beware that the Acquia needs 6 holes in the floor to install!!