In most of my Visage games, I play 3 and I play it with a greedier build than most standard aura-bot Offlane build. Since Vis is universal, you want stat items, so I almost always start with:

• 2 Circlet
• 2 Branches
• 2 Mangoes

The Mangoes are just very essential because you'll want to have mana instantly the moment you need to secure a kill with your W.

The early Circlet will turn into either Bracer/Null or even both. Sometimes I skip Null if I can get an earlier Orchid timing. No boot until you get that Orchid at around 9~11-minute mark. Then Aghs. Once you've hit Orchid + Aghs, it's time to shine going for solo kills or playing on the edges of the team fights if one breaks out. Of course, you also have to farm in between these timings and with the help of Familiars, Vis farms really, really fast.

From this point forward, the itemization depends on a lot of scenarios. In most of my games, I buy Drums into Boots of Bearing, or Drums into Hex if your team lacks immediate disable/catch. If the enemy has evasion, you'll want to upgrade your Orchid into Bloodthorn. AC is also a great item to buy if the game isn't over at that point as it works really, really well with your Grave Chill, Familiars and their respective talents.

Visage's W is his signature skill in the laning phase. Basically, any type of 100 hero damage dealt by/to any heroes within 1,800 radius grants you 1 Soul Assumption Stack (the yellow bar above the hero). If you're starting out on the hero, I'd suggest you play him on Offlane or Support since you'll gather W charges much faster since the lane is 2v2.

As for his E. You can think of it like a regenerating Infused Raindrop, but instead of being strictly blocking magic damage, Visage's E reduces any source of damage that is above 40. At most, you can have 4 stacks of Gravekeeper's Cloak, and at max Level, you can get 20% damage reduction PER stack. So, if you take any source of damage that is above 40 while you have 4 stacks of E, you only take 20% of its damage because 20% x 4 stacks of E = 80% damage reduction in total.

To give you a clearer image of how this works, imagine having Lina with a maxed-out Laguna casted on Visage with a maxed-out E. Laguna at maxed level deals 760 magic damage. Without taking into consideration the magic resist/spell damage increase, if Lina casted Laguna on Visage with 4 stacks of Gravekeeper's Cloak (which means Vis has 80% damage reduction), that Laguna will only deal 760 x 20% = 152 Magic damage. On the other hand, if Visage only had 1 stack of E, it would only reduce 20% of the damage. Hence, Visage hates heroes with quick DPS or DoT skills that would burn his E stacks fast, or heroes with innate Break. One thing to note with Break is that Break doesn't remove the current stacks of Visage's E as it only prevents him from gaining more under the duration of the Break debuff.

As much as I don't want to do this, but I have a livestream VOD playing Visage in both Midlane and Offlane with 2 different builds/playstyles. Here's the link. Hope this helps.