this seems pretty shifty imo. perhaps not negligence, but certainly questionable conduct.
if youre going to remove fat for cosmetic reasons, the doctor should take various factors into account that could affect the outcome of the lipo - gyno is one of those underlying things that, imo, should ahve been picked up on, because 1) it affects the appropriatness of the reccommended lipo and 2) would affect the cosmetic outcome of the surgery. a simple ultrasound is niether inconvenient nor invasive, and therefore should have been performed by a competent doctor.
the bottom line is that it is not unreasonable for a doctor to examine a patient well enough to get a good outcome as a result of their surgery. end of story. get on the phone, chase them up, and see if you can compromise ie get the gyno corrected at a discounted price, or its lawyer time