If you're doing a coke bottle shaped handle with pins it's pretty easy to keep fairly good symetry from side to side and top to bottom as the pins will help in setting grind stops, etc.
If you only have the one pin or bolt, like a mortised tang might, just be careful and it helps to have a good eye. As long as you don't take off too much there's always a way to fix it by matching the other side to it.
Take off way too much and you learn what frustration is, when you have to start over.
I've not made any round handles, like British Commando knife style, so I've never had the need for a lathe. I've also never had to use drawings on my handle to keep it right. I envision what I want and just do it.
I use the vertical flat platen, whatever sized contact wheel I deem necessary, but only rarely a slack belt. I just find them too imprecise.
In very tight places I will use a file(s) or sandpaper wrapped dowels, etc.
The more experience you have at it, like always, the easier it is to do.
Don't overheat you handles when grinding. Treat it like you would heat treated steel as it can react badly to heat(some of it). All of it will react badly when you're grinding pins or bolts. If they overheat, it breaks the epoxy bond and will, or can leave a dark ring around the pin/bolt. Heat it bad enough and the handle can warp and let go from the tang in the area you're grinding.
Some woods will crack badly if overheated so that's another reason to use good belts on them unless you're going very slow(another reason VS is a good thing).
