In Japan, people don't make a big deal about birthdays, particularly when it comes to adults. Often, celebration extends only so far as taking a friend out to dinner and/or serving up a "surprise" cake. It's very rare for people to give each other actual gifts except perhaps something very modest like a bit of chocolate or a small cake from a designer shop. In America, adults often feel burdened by birthdays as they are obliged once a year to conjure up an appropriate gift for someone who doesn't need anything or who they don't know particularly well.
While I'm happy to convey birthday wishes and give gifts when I really want to, I'm happier living in a culture without the expectation that presents will be proffered on adult birthdays, and I'll miss that.
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