There is so much metallurgy that goes into designing a piston I doubt that you could mill / lathe one out that would compete strength wise with something a reputable piston manufacturer makes. If you had some odd ball motor that nothing at all was available for you could mess around with it, with the understanding that if this part breaks on a running motor, bad things happen.
They are designed to be light yet strong, and expand properly when heated. Most of them are not round cold from what I have been learned, because the way they expand when heated.
What do you need a piston for? You could get your bore measurements and start digging though catalogs to see if something can be adapted from another motor.
On the other side, if I had a lathe, and the time, I would probably give it a shot if I didn't care about the motor.
