First, you have to clean your ears -- REALLY WELL! Use a cotton swab, and there is special wax removal fluid in the "drug" department of Wal*Mart, most grocery stores, or an actual drug store if you want to get them very clean.
Having clean ear canals is NOT important for health, and may be a bit counter. Anyway, be sure you don't touch the ear drum with ANYTHING.
As a touch up, and as a final cleaning before inserting the canal phones I use a pen cap. I scrape the sides of the ear canal, then dispose of any wax or dry skin cells on a tissue. There is no way I can get to the ear drum in my ears with a pen cap. Yes, I am writing about a cap of a Bic pen or a generic version. Most generic versions are better as they are not as pointed and are thicker and stiffer. It is important this final cleaning be done just prior to inserting the canal-phones, as your ears will quickly fill with wax.
Next, lubricate the flanges on the right canal-phone. I use spit, but I suppose K-Y or anything similar would work, as would saline for your eyes (contact lenses) or nose.
Now, this is the part people miss -- reach over to your right ear behind your head with your LEFT arm. Grab the top rear of the ear and pull it back and up. The direction is about 10 or 11 O'Clock if viewing the right ear straight on. This straightens the ear canal, making it possible to get the canal-phone where it needs to be located. This is the same for ear-plugs used for hearing protection, as in while shooting. They MUST BE FULLY INSERTED!
Now, with a steady pressure, insert the canal phone until the last flange is even with the ear canal, or just a BIT further in.
Lubricate the left flanges.
Then do the same with the other ear. Grab the left ear with the right hand, with the arm behind the head. Once again, pull back and up. The direction is about 1 or 2 O'Clock if the left ear is viewed straight on. Insert with a steady pressure until the flanges are fully inside the ear canal.
Rotate the drivers as needed, and route the wire. Clip the wire to your shirt and you are done.
When removing the flanges, use the fingernails and try to break the seal while removing them. Pull SLOWLY until the seal breaks, or they are out. If you yank them out, you could damage your eardrums.
CLEAN THE FLANGES. Leaving any ear wax in the flanges will allow the wax to get into the filters.
I know that people have discussed reusing the filters after cleaning them, but I wonder if all of the wax can be removed with water. I would be concerned about getting wax or water into the drivers. This would ruin the driver, and thus, the canal-phones.
If you choose to take the risk, I would STRONGLY recommend using Isopropyl alcohol. You want it to be 99+% pure, and should not contain water or camphor. In other words, don't consider using rubbing alcohol. This will remove the rest of the wax, and should displace the water.
Alcohol will evaporate out of the filter MUCH faster than water, but because of the construction of the filter, I doubt either will evaporate in a reasonable amount of time. I would want to let the alcohol have a day to evaporate.
Now that I scrape my outer canal with the pen cap, I never mess up a filter, and rarely see wax in the flanges, except on very long flights where not only are they in for a long time, but occasionally have to be removed to speak with a flight attendant or purser.
For me, it just isn't worth it, and I would not consider risking my 'phones in order to save a small amount of money.