Elton John had surgery for vocal nodules in 1987 after a grueling 15-month tour with over 200 concerts. Following surgery his voice entered a new chapter after is vocal range was reduced.

The operation came after a particularly grueling stretch for the famously busy John. He’d spent the previous 15 months touring, performing roughly 200 concerts during the span, and as documented on his 1987 Live in Australia LP, the period found his voice worse for the wear. Telling doctors he’d experienced what the New York Times described as “spasmodic bouts of pain” during those dates, he admitted himself to a private hospital in Australia.

The procedure, announced Jan. 3, 1987, resulted in the immediate cancellation of John’s planned tour commitments for the year, including scheduled dates in North America — but reps immediately insisted there was no reason to fear the worst, saying John would be in the hospital for only a few days and he was “relieved that at last something is being done.”

Describing the surgery as “exploratory only,” they told the press it was “something that has to be rectified.”

To fans’ relief, everything went according to plan. Three days later, John was listed in “satisfactory condition” after the hour-long procedure, with reps telling the press, “It is hoped he will not need further surgery. There’s every possibility he will not.”

What exactly was ailing John was a matter of intense speculation. The Australian papers reported he’d developed nodules on his vocal cords and he was rumored to have throat cancer, but a publicist described the problem as a “non-malignant lesion” — and in any event, he was back in action quickly, releasing his 21st studio LP, Reg Strikes Back, in 1988.

John returned to performing soon after the surgery, but his vocals developed a noticeably different sound, rounding into a deeper timbre that he’d continue to grow into over the latter decades of his career.

It wasn’t an evolution all fans were eager to embrace, but for John, it represented the start of a better, healthier way of using his vocal instrument.

“My voice is the thing that’s really improved the most over the last few years. There’s more resonance to it,” he told Billboard in 2004. “It started to change when I had the operation in Australia after the live album, because of the nine cancerous … whatever it was on my vocal chords.”

Acknowledging that fans who lamented the loss of his falsetto were right “to a certain degree,” John insisted that he still performed much of his catalog in the original key — he was just singing it more fully than before.

“I haven’t taken them down, but I just have more resonance in my voice and I’m much happier with that,” he added. “Halfway through my career I got a voice change, thanks a lot! And I’ve learned to breathe properly, I’ve watched other people singing, I’ve become a much better singer. I’ve become a singer that plays the piano instead of a piano player that sings.”

Whatever your point of view on John’s latter-day vocals, there’s no denying they’ve changed — and although it was definitely worth it to do whatever it took to keep him performing, it’s understandable that longtime fans might feel nostalgic for that classic Elton John sound.