Can you build a small soffit between the top of the two medicine cabinets and put some recessed lighting in that? That would be your best option I think for that area.

A designer suggested to me that I consider hanging pendants over each of our sinks on our dble. bowel vanity. You may want to consider a similar idea. Im not sure what type of "style" your wanting for your bathroom but you could either hang two small chandeliers on each side of your sink or two pendant lights (there are some nice industrial looking ones out there).

Since you have existing wiring, consider changing the lights. We updated our Powder a couple years ago, replacing the original builders' over-the-mirror fixture with pendants. Ours are low-voltage, dimmable halogen. We've been very pleased.

Here is a link that might be useful: Our Powder Room

fnmroberts, I really like what you did with your powder room.

Our lights are mounted in the middle of the ceiling over the vanity and then swagged to each side and then hang down with chains. We're going to put a recessed light in the middle where the current mount is and then run wires to each side and still use a pendant lights, only these would be more up to date.