I've had ~10 punctures in a 28 psi tubeless mtb tire simultaneously by riding over a goathead patch (ugggg), and pulled each goathead out (a 6 o'clock) and let gravity and the sealant do its thing with zero/marginal loss of psi. And in fact, during the 2,000 miles of tubeless mtb I've done, I've never had an actual flat. And even with that 100% success rate I'm still on the fence about tubeless on the road, due to all the naysayers.