I have custom earplugs too. They're molded to my ears and have changeable filters that I can swap for various occasions. I use the 30 dB filters for loud concerts which I attended when I was younger )not so much these days) and 10 dB filters when playing in a bigband, depending on the situation. I started using these after noticing one of my ears having issues every time I played with one of the bigband in certain locales. If the locale was low, the loudness of the lead player next to me would be too much for my ears to handle.
Now, I don't like playing with earplugs, because part of the sound resonated from the mouthpiece through my skull and that's annoying and it throws my intonation off a bit, but that's a small price to pay.
I've also noticed the custom earplugs being much more comfortable to wear than standard earplugs. It irritates the skin way less, especially if you maintain them correctly.