There's nothing "the joker" about this pic. There's none of the makeup or anything like that. For the creepy expression, the yandere tag covers it fine.
Eat your heart out, birthday boy. Mwahahahahahaaaa!!!!
I would accept that cake, but I'm allergic to milk,flour and eating human body parts. Huh? What's that? You mean this human meat bun? Uuhhh...I can explain?
Am I the only one having that scene from South Park playing back right now. You know the one where there was this Chili contest, and Cartman uses his enemy's parents as meat for the chili? Odds are that (or some significant other) is most likely in it.