{Wouldn't this be considered an "Unbirthday" because it's a day late, though?)

Ye gods! *huggles, cake, a sling and a sack of pebbles to throw with it, and a basket of Bleeprin-berries*

Congratulations on surviving your second decade!

...A sentiment which garners a whole new meaning after reading that list of terrible, terrible things you've survived through. Kinda makes me feel like a loser for being proud of two broken limbs in nineteen years...

Anyway, yes, happy birthday, Riese! Here, have a giant birthday huggle! -proceeds to huggle the [PUDDING!] out of you-

Chocolate cake for everyone!

Here, have some variations from the wonderful Victor Borge:

https://www.youtube.com/watch?v=Ajg7FlPv0HU

*Throws cake and confetti*

Wow, that's a lot of ways you almost died. Have a set of figurine golems from your favorite canon! They're basically what the name implies - enjoy having tiny posable characters with switcheable faces and weapons running around in your RC!

Why so surprised? I thought Inquisitors of the Red Fist were naturally hardened to pain, hmmm?

Grats on twenty, I'll be exactly two years short of you in April.

Be afraid, Riese.

Be very afraid.

Oooooooooooooooooh. Ghost fingers.

Happy 20th birthday! That's a lot of near-death occurrences, man, have some congratulatory chocolate or something.

Sounds like you've been through a lot! Happy Birthday, and good luck in the future! (Of course, I know nothing of being 20.) Have a random box inside of another box inside of another box. All wrapped in shiny urple paper!

20 years old, well done good sir, well done on surviving this long. As a gift, I give onto you one Pinkie Pie Premium Party Pack. Pinkie Pie and her party cannon will make sure your birthday is a blast! Oh, and if you are afraid it's going to be one of those 6 year old's birthday parties like she usually does, let me put your fears to rest. The Pinkie Pie Premium Party Pack is not like those other parties, as it is not a canon party. Oh no, it's a FANON party. The highest quality Sweet Apple Acres cider (non-alcoholic if the legal drinking age is 21 where you live), catering from across the multiverse (she is a forth wall breaker after all, she got connections) and music from the one and only DJ PON-3. Further, with the aid of Dr. Whoves and other Time Lords (turns out Gallopfrey was not destroyed by the Daleks in this universe), your birthday party will last an extra 3.573 hours!

Happy Birthday from me,
(and Jumper.)

Wow, your life is either a lot more exciting or scary than mine. Felis Cumpleanos!

Here is a three tiered, sparkly pink birthday cake, with twenty candles. The candles are sticks of dynamite, lets see how you survive that! *laughs maniacally*

Have this complete safety gear kit, a bulletproof vest and a coupon for a free rescue by Madoka Magica's Madokami (or by Homura Akemi, depending on the situation). Judging by what you just said, you're going to need all of that.

It would be a very intriguing read, from what I can tell.

A very happy birthday to you! Alas, I don't have much to offer in terms of gifts, but if you'd like, I could sketch a character of yours, maybe? I don't hold claim to have any particular skill with the pencil, unfortunately, but I've been told I can scribble fairly decently.

Unless you're exaggerating. Then yeah.

Anyway, Happy Birthday!