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Re: what happens...
You shouldn't have to pull the head, and neither should your mechanic. A good quality drill and bit should be all the guy needs to do the job if you don't want to do it your self.
That area gets incredibly hot and those little bolts can seize themselves in there. You may want to put some anti-seize on the new bolts. They shouldn't loosen themselves up all that often. If you are worried about it then just check the torque on the bolts every couple of weeks until you feel confident that they aren't slowly loosening and then check them every month or so. With a proper exhaust manifold gasket, even a loose bolt won't allow the leak.
If it was me, I would keep the exhaust that you have, get the bolt fixed, order a new exhaust gasket and be on your way. The machinist shouldn't charge you more than a few dollars and the gasket is like $8. That's a whole lot cheaper than new everything.
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