These kinds of installations are not for beginners. They are much quieter than what we had previously and definitely passed the tissue test. Awesome fan. I spent time making sure the install was as mechanically sound as possible (used foam rubber gasket at drywall interface and one 45-deg bend on the 6 inch duct) and it's so quiet you can barely hear it running. I didn't have sufficient vertical clearance in the old fan's location so I make an entirely new hole a few feet away and the existing roof outlet was 4 inches, not the 6 inches the new fan needs.