We have our triple light vanity fixture facing down. I do stand at sink and put on make-up. We deliberately chose fixtures to face down because we also have high ceilings and wanted to make sure lighting was good. The mirror also helps to reflect the light. 100W bulbs could be used, but we only use 60W.

In our previous house, DH installed a new light fixture in our main bathroom and had the light facing up. Lighting was not bright enough for me.

Ours currently face down, but I have previously had upward facing lights.

The downwards definitely direct the light better when you're trying to see yourself or do anything in the mirror, but my big thing was all of the dust and bugs that end up falling into the upward facing lights! Too annoying to clean for me...

What about sconces on either side of the mirror? Do they give enough light? Does the direction matter with them?

I have 12' cathedral ceilings in my master bath and I did a fixture that went up AND down. I just thought with the height of the ceilings there....the larger fixture would look better. Both lights have switches, so I can turn a set off if I want. The lights are wired to one switch too.

In the photo below, you can see the standard down sconces in my makeup area.

Here's a photo.

Well how cool is that! I've never seen lights like that. Side lighting is more flattering but downward pointing lights from above will offer better lighting.