Boil the pasta. Bring a big pot of salted water to a boil. Add fettuccine and cook until it is just tender. Before draining, scoop out about 1 cup of pasta water and set it aside.

Start the sauce. In a large skillet over medium-low heat, melt the butter. If using garlic, add it and stir for about 30 seconds until it smells amazing but does not brown.

Add cream and gently simmer. Pour in the heavy cream and let it warm up for a couple of minutes, aiming for tiny bubbles around the edge, not a rolling boil.

Add Parmesan slowly. Lower the heat. Add the grated Parmesan in small handfuls, stirring constantly so it melts smoothly. If the sauce looks too thick, add a splash of reserved pasta water and stir again.

Season and toss. Add salt, lots of black pepper, and a tiny pinch of nutmeg if desired. Toss in the drained fettuccine and coat it well, adding more pasta water as needed until it looks glossy and creamy.

Serve right away. Alfredo is happiest fresh. Top with extra Parmesan and more pepper if desired.