Bring a large pot of salted water to a boil
Add fettuccine and cook until al dente
Reserve some pasta water
Melt butter in a large skillet over low heat
Add minced garlic if desired and cook briefly
Pour in heavy cream and warm gently
Stir in grated Parmesan cheese until smooth
Season with salt and black pepper
Add cooked fettuccine to the sauce
Toss to coat, adding reserved pasta water as needed
Serve immediately with extra Parmesan if desired