I've tried to wear them cable-down and although I could, I didn't like it much because the phones tended to slide out of my ears that way, if I used silicone tips.
I've already talked about the tips. In the end, only my homemade foamies did the trick in terms of comfort and isolation. I don't have Comply tips compatible with this model, and it's a pity because I think they will be perfect. Meanwhile, I have other foamies I can use.
I'm very sorry for not being able to use the provided silicone tips. Foamies are a pain in the arse when inserting the phones, but silicones didn't offer comfort and good seal to me. Maybe it's the design, who knows, or maybe it's a problem with my ears, but phones usually tend to slide out of my ears, specially from the right ear. With most phones is just a matter of finding the silicone tip that does the trick (fake Sony hybrids usually work great), but with the A151 I didn't have any success. For me and the A151, foamies are the way to go for now.
The housings are a bit on the big side, but nonetheless the phones can be inserted deep without problems. At least I didn't have problems, and my ear canals are weirdly shaped. They allow for a bit of rotation once inserted, so you can move them a bit in the ear to gain additional comfort.
Noise isolation, sound. To be sincere, the sound signature of the A151 is not my favourite (I'm a lover of the CC51 sound signature), but they have surprised me. I thought that I could only use them when I do critical listening, where picking the details is important but you won't enjoy the music much. I was wrong, I can do critical listening with them while at the same time enjoying the music, because the sound signature is not cold or harsh, no matter the amount of detail and accuracy you get. I really like this, because I thought that I would never find a balanced armature that I really enjoy.
First thing I noticed is that even at low volume there’s a lot of clarity, detail and accuracy, which is the same I thought when I first used the SoundMAGIC PL50. At normal listening levels, the degree of detail and accuracy is just incredible. I've discovered new details in my music that even the PL50 missed. Problem with this is that the A151 are very revealing about source limitations. If you listen to poorly encoded music or your source just stinks, the A151 will throw that in your face.
Second thing I noticed: no need to amp them at all. My Clip+ didn't had any problem moving them, and adding the FiiO E5 to the equation didn't improve things much (well, basses improved a bit).
Third thing: the basses doesn't suck. I haven't tried the Westone 1, but the SoundMAGIC PL50 had very weak basses in my opinion. In fact, that's the reason I don't use mine (my wife likes them, though, so she's using them happily), I feel like music lacks presence, and from what I've read, that's a common problem of single balanced armature entry models. Not with the A151.
I have to make things clear here: you won't get the basses of the M11+ or the CC51, even the CX21 has more basses than the A151, but compared with the PL50, the A151 kicks a**. The basses are clearly there, they have impact and they're very well controlled if you ask me. They lack in depth, that's the price you pay for balanced armature drivers, and the sub-bass response is... well, armature like (almost missing).
The mids are probably the part of the A151 sound that I like the most. Balanced armature drivers are very detailed in the mids, usually, but at times they sound cold, analytical, and that ruins the overall effect. The A151 add a bit of warmness to the mids (well, to be sincere, to the entire spectrum, is a characteristic of its sound signature), so you can listen to Sade, for example, with great pleasure. Female voices benefit from this added warmness and thickness, no doubt, and that's why this is the point I like the most about the A151.
The highs are very detailed, but not harsh. I haven't noticed any sibilance, which is good, but I miss a bit of sparkling. And not that I think the highs are laid back, but I wouldn't mind them being a bit more forward. No complains, though, because in my limited experience, when highs tend to go a bit forward, harshness and thrilling sound are waiting for you...
At times, they’ve sounded congested, or for a lack of a better word, crowded. Not exactly the phones fault, as the same music also sounded congested with other phones, but the A151 showed this problem more. This may be caused, probably, because the revealing nature of the phones. Well recorded music sounds great, but poorly recorded music sounds even poorer than with more fail-tolerant phones.
Soundstage is only average to my ears. The CC51 were better here, in my humble opinion, and they haven't a very wide soundstage either. It is more than decent, though. Instrument separation and placement is superb, as it should with the level of detail the A151 gives.
Noise isolation is slightly above average. I would have expected a bit more of isolation from a balanced armature, but well, when music is sounding the isolation is quite good. Probably if I could find some silicone tips that work for me, isolation would be better. With homemade foamies you can have isolation problems if the foam is soft, for example, so I don't want to judge A151 isolation from my experience, as I know other forum members consider it above average in these phones.
Summing up: For a slightly warm sound signature, together with the accuracy, clarity, detail and speed of a balanced armature, this phone is perfect for the price. Being a bit more expensive than the SoundMAGIC PL50, it offers better bass response, better ergonomy and better building quality, so the price difference is justified.
For the same price and an alternate sound signature (colder, more balanced except for having more and better basses), you can buy the Meelec CC51. For the same price and sound signature... you will have a hard time finding something

I don't know if Meelec has plans about releasing a dual armature or something like that, but given the quality the A151 gives for the price, anything above it would be just marvellous. I would love to see housings on the line of the Ety ER4, because they would be perfect for my ears and would give the noise isolation I desperately search in IEMs!
A great phone at a great price, but with a balanced-armature sound signature, so caveat emptor.
Comments and questions welcome, as always! Hope you enjoyed the review.