I have come across these beautiful handmade birthday cards themed around the Birth Flower of each month.

Do you still buy birthday cards?  I think the ecard has certainly made its inroads on this tradition, but in my case I at least get to send ecards to a lot more people than I ever used to send 'real' birthday cards to :) 

Of course family still get 'real' birthday cards, although I must say I never thought of buying cards online - there is such a lovely selection!