Place a wide, shallow pan over gentle heat and melt butter.
Sauté minced garlic until soft and fragrant, approximately 2-3 minutes.
Add heavy cream and bring to a medium simmer.
Gently reduce the sauce by 1/3rd. Sauce will slowly thicken.
Once reduced, add 3 Tbsp lemon juice and 1/3 cup reserved pasta water .
Continue cooking until the sauce lightly coats the back of a spoon (10-12 minutes), taking care to ensure that the sauce never reaches a boil.
Continue reducing for 5-10 minutes more, adjusting for acidity by adding more lemon juice if needed.
Add parmesan cheese and whisk until smooth and fully incorporated and cook 5 more minutes.
Remove from heat and taste for seasoning, adding more salt if desired.
Pour hot sauce over cooked pasta and gently fold in dill, cracked black pepper and salmon meatballs.
Garnish with extra parmesan and dill.