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Ruffles and flourishes are preceding fanfare for ceremonial music for distinguished people.
Ruffles are played on drums, and flourishes are played on bugles. For example, the President of the United States receives four ruffles and flourishes before "Hail to the Chief." Four ruffles and flourishes is the highest honor.
Although roughly equivalent, the United States Navy has a different "Table of Honors" – some civilian officials more, others less; often different musical tunes – and includes in its arsenal of formal Honors one more, which is specific to naval traditions: Sideboys, an even number of seamen (in this list 8 for guests with quadruple or triple ruffles and flourishes, 6 for lower ranking dignitaries) posted at the gangway when the dignitary boards or leaves the ship, historically to help (or even hoist) him aboard, presently as a ceremonial sort of guard of honor.
Four ruffles and flourishes played before "Hail to the Chief"