All the people we love with 'whiskey voices,' they have that sound for two years," John Mayer says. "After that, they start singing everything an octave lower." In fact, artists now utilize every treatment available to preserve their distinctive timbres during what appears to be an unprecedented spate of vocal strain-related issues in pop music, affecting careers with quantifiable impact.

Adele's recovery from vocal-cord surgery--climaxing in a spectacular comeback performance at the 2012 Grammy Awards--remains the most famous example, but others abound. As far back as 2005, it was feared Justin Timberlake might not sing again after going under the knife to remove vocal nodules before releasing his smash "FutureSex/LoveSounds" album in 2006. More recently, Rihanna canceled concerts in Baltimore and Boston on doctor's orders due to a bout of laryngitis. Keith Urban, Maxwell, Art Garfunkel, Florence Welch, Nicki Minaj and Imagine Dragons all canceled tour dates due to vocal strain-related issues in the past two years.

"Cancellation insurance is expensive," says Tom Windish, founder of booker the Windish Agency. "Insurance for lost revenue and expenses due to medical reasons costs artists and promoters anywhere from 2% to 5% of guarantees. Also, tying into marketing on the heels of a new album is important: Tag advertising for the album mentions shows in each city--if you miss that window, it might be too expensive to buy those ads again."

Some claim the problems stem from the music business' shift to live performance and 360 deals, along with 24/7 promotional and marketing demands. "A big part of the problem nowadays is that artists are required to do too much at once," says Santigold, an artist who's suffered vocal swelling in the past.

"If you've got to do certain things to promote what you do, the vocal cords see all that mileage," says Dr. Steven Zeitels, the surgeon who's treated vocal ailments for the likes of Urban, Adele, Steven Tyler, Roger Daltrey and Lionel Richie.

That's what pop singer Christina Perri discovered when she was diagnosed with a vocal-cord cyst just after signing with Atlantic Records and her 2010 hit "Jar of Hearts" had started buzzing. Perri postponed treatment to complete a year of promotional commitments. "Everyone--the label, my manager--were like, 'It's really not the time,'" Perri says.

According to Zeitels, who treated Perri, it's always better to attack the problem than ignore it. However, despite her yearlong wait, when she returned from surgery her voice was better than before, he says. "Once the mass on her vocal cords was removed, they were perfectly pliable: It was like a basketball player suddenly got to play with weights taken off his legs."

Perri's bounce back isn't an isolated incident. "When we restored Keith Urban's vocal anatomy to levels of when he was 19 years old, afterward, he said, 'I've never sung like this,'" recalls Zeitels, who claims recent advances in the field, from laser technology to new surgical instruments, will produce even more success stories. He points to his development of a new biogel that he claims will be a "holy grail" for tortured vocal cords.

"Injecting this gel will make vocal cords softer and change their pliability so singers can do things they could never dream of before," says Zeitels, who serves as director of the Center for Laryngeal Surgery and Voice Rehabilitation at Boston's Massachusetts General Hospital. "This gel could create 'super singers'; it's the equivalent of, say, a world-class pole vaulter operating in decreased gravity. We're on the edge of human trials. We may see this gel in five years-it's not a question of 'if,' but 'when.'"