PG was wrong to say that you cannot be too strict about historic preservation because it leads to the exact problem we have in SF right now -- there is no physical reason this city can't be more dense and remain beautiful (look at Paris for an example of how this might be possible), but there are many, many political reasons.
There are also economic reasons. Parisian density is only possible with a great underground transportation system. That's hugely expensive to build and takes decades. SF has traditionally been a boomtown economy with corresponding bust cycles, so it's harder to make those kinds of investments. They are happening (e.g. the Chinatown extension) but more conservatively.
Saigon where I'm back from is building a light rail to the center with twenty odd 30-40 story residential blocks along it. The whole thing is taking about 2 years to build.
That kind of thing is good for preserving historic buildings too - the blocks are all in nondescript areas 1-4 miles from the center.
I'm mainly just talking about the density -- many more people fit into less space than in San Francisco. And its both an option for us to build up, and build in -- we could close down some of our wider car-oriented streets and build walking/biking oriented roads.