Visage presents himself as more intimidating than his actual required prowess suggests, despite being a micromanagement hero.
Though his skill set can be quite demanding at times, a perfect play style is far from necessary if you wish to succeed in your lane and eventually secure your game.
I hope this guide redirects your fear from Visage towards his enemies instead. If you have any suggestions or questions, feel free to ask or comment below.

No matter what patch you're currently on, know this:
Visage's build stays, for the most part, exactly the same as it always has been; what changes is your approach towards certain heroes and their builds. Some extension items can also be helpful, but the core remains the same.

In this guide, I'll be ranking skills and items (as well as neutral items) based on their suitability for aggressive gameplay. Adjust it to your play style and whatever best suits you.

Some notes:

• Visage's peak is at lvl 6, being able to gank other lanes with ease using a single smoke, shutting down important cores or helping out those in need. In case your opponent has an advantage over you mobility-wise (Puck, Queen of Pain, etc), punish them by taking their middle tower much faster than expected.
• Don't shy away from modifying this build in any shape or form. Use it as a basis, but ideally, make constant adjustments depending on the enemy lineup and your own.
• Contrary to popular belief, you don't need to micro your familiars perfectly - you can just control all your units at the same time. There is room for mistakes. You'd be surprised seeing how some people play him in the Immortal rank.
• Train last-hitting with Visage on his own, then together with his familiars, either in a private lobby or Demo Hero, as there is a clear difference timing-wise.
• Visage depends a lot on his own team to be effective, as they have to play around him and his auras to get stuff done. You won't be doing much late-game, so use your time wisely.
• No matter how well you play, you will be counter-picked at times. And that's okay.

My keybindings are as follows:

• Select all Controlled Units: V
• Select Hero: X
• Next Unit: C
• Select all Other Units: SPACE

This means that stunning with my familiars requires me to simply press C and Q afterwards.

-- May 2024 Update: --

Once more, we are returning to an aura-based build instead of crowd control.

Hero facets:

• Sepulchre: Ideal if you are used to microing and want to take full advantage of the Grave Chill area debuff, as it keeps the hero pretty much the same. With Alt + Q, you are able to change the familiar's skill to become point-and-click, allowing you to choose where they will land with precision, albeit slower than simply casting the skill immediately. In actual teamfights, though, you'll want to choose speed over efficiency, so I recommend turning it off. The stun is also canceled if you are moving Visage AND his units at the same time before the familiar reaches its stun destination, giving you an even bigger time penalty. Returning the birds with R is also pretty convenient and time-efficient when split-pushing, but I recommend deactivating it as it's on by default (remember that Nvidea/Geforce has an Alt + R shortcut as well, so make sure to change it beforehand).

• Death Toll: Especially as an offlaner or support, this facet will do you wonders when it comes to securing items early, profiting off of kills even if they aren't your own. As the game progresses, your hero will fall off much quicker than others. So, make sure to capitalize on your advantage in the early stages of the game, if the lineup allows for it. Since this effect lingers for 3s on the enemy and Soul Assumption has a ridiculously low cooldown, it is unlikely that you will miss the benefits from it, even if it reduces gold received from creeps. As you depend a lot on your own team's competency and it seems to provide a disadvantage mid (as you will be 1v1ing and the enemy midlaner will have a fatal gold advantage over you, regardless of how well you gank), choose this facet with moderation.

• Faithful Followers: A higher range for the familiars' stuns, albeit its damage remains the same. However, given the lack of control over your familiars, you are practically unable to protect them efficiently or chase prey without putting Visage in danger as well. It becomes impossible to split-push with the familiars alone or take advantage of their global range by blocking or taking enemy camps, as well as denying runes, which is essential at minute 6. It is ideal for a mindless or easy type of gameplay, but not one for higher ranks.
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A bit about me: I've dedicated nearly a decade to mastering Visage, playing well over 2,400 games with him. I've climbed from Archon to Divine with this hero and been on the top boards with him before, so I'm confident in my insights into item building and play style. Even though I will never stop learning about this hero or this game, I've compiled my current knowledge into this guide in the hopes of assisting others in their journey to higher ranks. Nevertheless, I still encourage you to explore high-ranked gameplays and resources like Dotabuff's top 100 page. The pursuit of knowledge knows no bounds!

But most importantly of all: just have fun!!
After all, someone who works hard can never beat someone who enjoys himself.
~James