Should I get a medial epicanthoplasty with an upper Blepharoplasty? (photo)

It all depends on how big crease you wish to have on your upper blepharoplasty. Attractive eye need adequate ratio between horizontal length and vertical length. Upper blepharoplasty increase vertical dimension not horizontal length. Your photo shows that  you have adequate horizontal length so you may not need to have epicanthoplasty.  Inner half of upper lid shows steep upward slope and this may be due to redundant skin at the lid margin. Overall your eye has good ratio between vertical and horizontal length.

You appear to have a partially formed upper eyelid crease in a parallel configuration.  A blepharoplasty procedure will help to define your partial creases and will frame your eyes in a way that they will appear bigger. You also seem to have a more prominent epicanthal fold on the left, but neither of your epicanthal folds are significant enough that epicanthoplasty is mandatory.  Many cosmetic eyelid surgeons will recommend against initial epicanthoplasty in your situation because of the risk of visible scarring.  You can elect to have the epicanthoplasty later if the folds become more significant or if you want to address the asymmetry, but it unlikely that you would need to do so. It appears that some of your asymmetry is caused by your left eye (and brow) position, which is lower on your face than your right eye. 

Looking at your photo, you do not appear to have a strong epicanthal fold in either eyelid.  Upper blepharoplasty alone with a design of an eyelid fold that can lift your inner corner should give you a nice aesthetic result.  I do not think medial epicanthoplasty is necessary in your case.  Good luck!