You can replace just the piston with the hole in it without any major problems. I had an old s-10 with a 2.5 4 banger in it that blew a head gasket in a bad part of town at night, so i drove it 20+ miles back to the shop i worked at, pulled the head the next day and #4 piston had a hole the size of a quarter in it, replaced the piston, associated gaskets, and put it all back together. It ran fine after that, eventually had to replace the head as it had some hairline cracks in the valve seats, but not into any coolant jackets.