That seems like such a hypothetical situation, but I (as a client only, not a tattooer) imagine the same "rules" stand - if you really aren't digging it, give the artist a little more insight into what you want and ask for it to be re-drawn without being a dick. I've never been clear on whether or not drawing time is part of the hourly rate or not, so just go with what they charge you at the end.
When I got my Rose of No Man's Land, I came to the appointment with a whole mess of references that I liked bits and pieces of, but the artist didn't even ask to look at them. He drew up his version of it (and I've loved most all of his similar work any way), and while it wasn't necessarily what I had imagined for my tattoo, I realized that it was a great piece of art and I didn't really have anything to say against it. I fucking love the tattoo, and even though it probably wouldn't have been my first pick of designs it fits the spot perfectly and I have no complaints.