While square mileage is certainly a limiting factor, we've hardly scratched the surface in vertical height. SF's population density is embarrassingly low for a city with such demand.
It's due to earthquakes I assume, since the building safety codes are probably super strict. I was just recently in the Saleforce tower, and had the chance to visit floor 55. Yeah, fuck that, the wind was making the office sway very slightly but noticeably. I can't imagine being on floor 55 during an earthquake!