Without seeing the space, my first inclination would be to gut the bathroom to the studs and begin from point zero, including removing all the lighting. But what does your designer say?

Post photos.

did post pic but not showing up for some reason....try again..

We removed a box light in our kitchen then repaired, textured and repainted ceiling. We used the electrical that was up there to hang pendants. In a bathroom, I'd probably put in recessed LED can lights. Or if you want a ceiling light fixture plus some can lights, that could work also. As long as you'll be messing with the ceiling, go ahead and put lights wherever you need them.

If you're on your phone, wait until the picture is totally clear before you hit the submit button. If you hit submit too soon, it won't post.

Do not trim out the box that will scream you used to have a box there remove it all redo the ceiling in a nice smooth finish and depending on the size of the sapce pot lights and some good lighting to do makeup at the vanity too. If you use all LED bulbs you could probably run all the lighting from one electrical box

Here is a pic

houzz pic upload issues....frustrating..

I would remove it.