That's a great question because they are different but can look similar and occur together. Alar retraction is the edge of the nostril raised up to high. It is often from prior rhinoplasty. A hanging columella is where the part between the nostrils, the columella hangs down too much. Both can create too much nostril show from the side. The hanging columella is easier to treat.
What is the difference between an alar retraction and a hanging columella? The ala is the nostril. An alar retraction usually refers to a high notch in the Alar rim. The columella is the structure between the two nostrils consisting of skin and underlying Cartlidge . when this structure hangs too low it is called a hanging Columella. Both an alar retraction and a hanging columella can cause too much of the side of the columella to be visible in the profile. A patient may have one or both of these issues